Available Therapies

Venous Closure Procedure

Micro-phlebectomy

Transdermal Laser or
Intense Pulse Light

Treatment of Spider Veins

Compression Therapy

Intermittent Pneumtic
Compression (IPC) Therapy

Exercise Program

Microdermabrasion

Modern Nutritional and
Anti-Aging Therapies

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All of these procedures offered at CVTC are safe and effective. When the diseased and defective veins are eliminated, the rest of the veins function better. They easily compensate for the abnormal varicose and spider veins thus actually improving circulation of the legs. Most of the patients report elimination of symptoms 98% in our experience. These treatment modalities may be done in combination with each other offering the patient the choice of treatment options with which they are most comfortable.

Venous Closure Procedures

• Radiofrequency Venous Closure
• Laser Venous Closure

These minimally invasive office procedures are done in the office to treat venous reflux in the superficial veins including Saphenous Veins, Accessory Saphenous Veins and Perforator Veins. Following these procedures the patients ambulate immediately and return to work the next day. The decision to perform these procedures is based on the findings of Venous Duplex Scan done during the evaluation of patients who present with varicose and spider veins on the legs. In majority of patients the Duplex Scan of legs shows reflux in the saphenous and the deep veins. The usual presenting symptoms are: pain, heaviness, tiredness, cramping, itching, burning and swelling of the legs. “Restless legs” is very common in these patients. Many patients complain of frequent bruising of the skin of the legs. A few patients have suffered from bleeding episodes and ulceration due to venous insufficiency which is underlying cause of varicose and spider veins and swollen discolored legs.

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Micro-phlebectomy
Removal of varicose vein clusters (Using ambulatory phlebectomy)

After the venous closure procedure of the saphenous vein, we recommend the removal of the clusters of varicose veins. We use the most modern technique that leads to no scars. After the surgery you will be able to return to work on the following day. If you have many clusters of varicose veins on your legs, these are done in multiple sessions, two to three weeks apart. We only do surgery on one leg at a time. The procedure needed for your condition is called multiple stab phlebectomies of the varicose veins.

This procedure is done on the same-day basis at the hospital or the surgi-center, and is done under local anesthesia with sedation. After the procedure is done, you will be left with 8-10 small punctures from where the varicosities were removed. No sutures are used. These tiny micro incisions are covered with clear plastic sheet which remains for 10 days. The leg is wrapped with ace bandage which is usually removed after 24 hours. The patient is instructed to start walking on the same day: and at night time elevate the leg on one or two pillows. The day after the procedure the patient is instructed to come to the office to have the bandage removed. The clear plastic sheet on the incisions should be left undisturbed; this allows the patient to take shower.

There may be some minor bruising related to the procedure, which can take 3 to 4 weeks to clear. We strongly recommend that the patients wear compression stockings on a regular basis and continue to perform calf exercises. One can resume normal activities on the day after the surgery. High impact aerobic activities should be avoided for at least 2 weeks.

Transdermal Laser or Intense Pulse Light (IPL) (The description in the present web page is post treatment instructions; it should be placed under Post treatment instructions-a new heading) These modalities are used to treat spider veins (venous telangiectasia). Currently, we use ND: YAG 1064 laser (Citon) for the treatment of spider veins and Intense Pulse Light (BBL-Citon) for the treatment of Rosacea and facial spider veins.

Spider veins are new growth of small blood vessels, under your skin, due to the release of growth factors because of the abnormally high pressure inside your veins produced as a result of incompetent venous valves. Each cluster of spider veins is connected to the deep veins by one or more abnormal, connecting veins called “perforating veins.” We had also recommended you to have high ligation and partial selective stripping of the long saphenous veins to stop the reflux of blood in a wrong direction to decrease venous hypertension. The spider veins, if not treated, will continue to harm you by perpetuating the venous hypertension, and new spider veins will continue to appear on other areas of your legs and make the condition worse over a period of time.

We prefer to treat spider veins with YAG laser, intense pulse light or diode laser-radiofrequency. We have found the results to be excellent and essentially no serious complications. We rarely see minor complications such as: superficial blister, hyper or hypo-pigmentation of the skin which are completely reversible.

The treatment with above modalities requires multiple sessions of therapy. Depending upon the type of veins, each area of spider veins may require 2-4 sessions of treatments 2-4 weeks apart. Electromagnetic therapy improves the quality of skin by increasing the amount of collagen in the dermis of the skin. This is why new veins do not grow back in the skin which is now thick and more like young skin.

Intermittent Pneumatic Compression (IPC) Therapy

Intermittent Pneumatic Compression (IPC) Therapy A few patients with venous insufficiency who have gross swelling of the legs with marked stasis changes including pigmentation of the skin of legs and stasis dermatitis have an element of lymphatic edema (lymphovenous edema). These patients continue to have swollen legs with minimal improvement after treatment of venous insufficiency and venous lesions (varicose and spider veins). They need daily treatment of their legs with Lymphedema Pump Therapy. This treatment has to be continued for many months and sometimes for life. If this edema is not treated, there is a high risk of developing chronic ulcers and DVT. We help our patients to get approved for this therapy. We have seen fairly good results with this therapy.

For the overall improvement of venous function in the legs daily exercise is mandatory. The heart pumps the arterial blood into the legs through arteries. The venous blood returns to the heart passively through the veins. There are five venous pumps in the legs which help this blood to flow properly. It is very helpful for the venous return from your legs if you can strengthen these muscle groups. These muscle groups are as follows:

• Foot muscles
• Lower leg muscles (calf and front leg muscles)
• Thigh muscles (front of thigh and hamstring muscles)

In addition, you need to strengthen your stomach and back muscles. I recommend a sequence of 7 simple exercises to be performed twice a day (morning and evening). You can perform these exercises in less than 4 minutes no matter where you are. Please remember, these simple set of exercises do not replace your other physical activities e.g., work-outs in the gym and daily walks. I encourage you to start a program of walking at least 2 mile a day. (The best way to achieve this goal is to do the walking in intervals of quarter miles. After each quarter mile, stop for a few minutes until your heart rate drops to the level before you started walking. In other words, measure the resting hear rate before you start walking. This is a proven technique to improve your general health as well.) If you can strengthen your above mentioned leg muscle groups, daily walks will be more productive to help the venous circulation of the legs.

Exercise 1
Stand straight on your both feet, one foot apart. Slowly raise your heels and then drop them to the floor. Now raise your toes as high as you can and drop them to the floor. Repeat this sequence 30 times. (You may start with few repetitions and gradually work up to 30. Initially you can hold on to something for balance, but eventually do these exercises without holding anything. This will improve your balance)

Exercise 2
Repeat the above exercise while you have all your weight on the right foot using the left foot for balance. Perform 30 repetitions.

Exercise 3
Repeat the above exercise while you have all your weight on the left foot using the right foot for balance. Perform 30 repetitions.

Exercise 4
Stand straight on your both feet one foot apart. Now lift your right leg so that your right thigh is parallel to the ground and your right lower leg is at right angle to the thigh. (You are standing on your left leg).Try to balance yourself in this posture. (Initially you may hold on to some object for balance, but eventually learn to be in this position without holding on to anything. This will improve your balance). Now extend your lower leg so that your entire right leg is parallel to the ground. Now bend your knee so that your right lower leg is again at right angle to the thigh which remains parallel to the ground. Perform 30 repetitions and then bring your right foot to the ground.

Exercise 5
Stand straight on your both feet one foot apart. Now lift your left leg so that your left thigh is parallel to the ground and your left lower leg is at right angle to the thigh. (You are standing on your right leg).Try to balance yourself in this posture. (Initially you may hold on to some object for balance, but eventually learn to be in this position without holding on to anything. This will improve your balance). Now extend your lower leg so that your entire left leg is parallel to the ground. Now bend your knee so that your left lower leg is again at right angle to the thigh which remains parallel to the ground. Perform 30 repetitions and then bring your left foot to the ground.

Exercise 6
Stand on your both feet one foot apart. Flex your body slowly forwards at your hips keeping the abdomen, chest neck and head in a straight line until your upper half of the body is parallel to the ground. Let your arms dangle in front of you as if you are trying to grab an iron bar parallel to the ground near your feet. Now slowly come up keeping the upper half of your body (abdomen, chest, neck and head) in a straight line. Perform 30 repetitions.

Exercise 7
Stand on your both feet three feet apart. Perform deep knee bend moving down slowly until your thigh is parallel to the ground. (Try to put your weight on the heels if possible. This will decrease the stress on your knees.) Perform 30 repetitions. Perform these repetitions very slowly. (If you have severe arthritis in your knees, you should skip this exercise). Modern Nutritional & Anti-Aging Therapies (needs completion)

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