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Patient Information

Insurance Information

Comprehensive Vein Care works with most insurance companies. We will get any procedures being done pre-certified before your procedure is performed. We will provide you with an authorization number so you can check with your insurance company for details of what your balance would be, if any. If your deductible is met, most procedures are paid in full minus your co-pay or co-insurance.

Pre-Procedure Instructions

Before Your Radiofrequency Ablation Procedure

We will call you before your scheduled procedure and answer any further questions you might have. We will also give a prescription for an oral sedative. You will bring the oral sedative to the office on the day of the procedure.

Clothing: A pair of loose, comfortable shorts will be provided for your treatment

Driving: You will receive a local anesthetic and an oral sedative during the procedure and will not be able to drive home. Please arrange for someone to drive you home. While the procedure takes only about one hour, you will be in the office for approximately 2 hours.

Eating/Drinking: Please drink plenty of water the day before the procedure. We encourage you to have a small meal one to two hours before arriving at the office. Please do not come to the office with an empty stomach.

Other: You will have a compression wrap applied to your leg after the procedure that you will wear for the first 48 hours. We will instruct you about when this will be removed.

Post Procedure Instructions

VenaSeal & Varithena Post Procedure Instructions

For the first 48 hours: Do not remove the bandages and compression stocking applied by Dr. Umerani. do not take a bath or shower. Keep bandages dry.

After 48 hours: Remove the bandages, but continue to wear a compression stocking.

For the first 7 days: Do not participate in strenuous exercise.

For the first 14 days: Wear a compression stocking day and night.

For the first 28 days: WWear a compression stocking day and night.

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Radiofrequency Ablation Post Procedure Instructions

   Return to normal activities.

   Ambulate (move about) at frequent intervals – at least 10 minutes every hour while awake for the first 24 hours.

   Wear compression bandage for at least 48 hours, followed by compression stockings for at least 2 weeks (3-4 weeks preferred).

   You may have some discomfort following the procedure. Some patients find it helpful to take a day or two off from work, although we expect you to be able to resume all your pre-procedure activities (including work) the following day, if necessary. If you have extreme discomfort or bleeding, notify the office immediately.

   Avoid prolonged sitting or standing in one place for the first week, and elevate your legs at least 3 times a day for 5-10 minutes.

   Avoid strenuous exercise such as aerobics, weight training, bicycling, or running for 2 weeks.

   Take analgesics as per physician’s orders: Tylenol, Motrin, or Aleve.

   Return within 7 days for a follow-up ultrasound.

   Return for periodic ultrasound follow-up, scheduled for 1 month and 3 months following your procedure.

Sclerotherapy Post Procedure Instructions

Compression Stockings: The compression stockings are critical to the success of the treatment. These are required to be worn immediately after each treatment. The stockings should be worn for the first 24 hours and then worn daily during the waking hour for 5 more days. We recommend thigh high or pantyhose with 20-30mmHg compression. We carry the majority of compression stockings sizes in stock at our office for purchase.

Driving: You may drive immediately after your treatment. We recommend stopping hourly to stretch your legs if your home is over an hour.

Bathing: Remove compression stockings, cotton balls/tape and shower the next day. Hot tubs and hot baths should be avoided for one week after sclerotherapy to avoid venous dilation.

Activities: You may return to work and resume normal activity after treatment.

Follow-Up: If you notice dark knots at your injection site, please call our office. You may need to return to have this area aspirated. The doctor or nurse will advise you when you should return for subsequent treatments. Remember, it is important to call our office if you have any questions or concerns before or after sclerotherapy treatment.

FAQs on Vein Problems

We’re here to help. Please feel free to contact us with any additional questions you may have.

Varicose Veins are swollen veins that sometimes look like cords. They often appear on the legs and feet. Some are visible through the skin, while others are not easy to detect.

Varicose Veins develop over time. If left untreated, they can lead to pain and swelling in the affected area and skin changes, such as rash and lesions. Varicose veins can also lead to more serious conditions, such as venous stasis (swelling of feet, ankles and legs that Worsens with leg elevation) or deep vein thrombosis (blood clot in a deep vein).

The procedure takes approximately 45-60 minutes, although patients may normally spend 2-3 hours at the medical facility due to normal pre- and post-treatment procedures.

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

The most important step in determining whether or not the procedure is appropriate for you is a complete ultrasound examination by your vein specialist. Age alone is not a factor in determining whether or not the procedure is appropriate for you. The procedure has been used to treat both women and men across a wide range of ages.

Varicose veins are caused by damaged valves in the veins. When you are in an upright position, the blood in your veins has to travel upwards, against gravity, toward your heart. Veins carry blood to the heart through a series of open valves to push blood toward the heart. When these valves become impaired or weakened, blood flows downward and pools, causing the veins to enlarge.

Varicose veins often appear in the legs due to increased blood pressure inside the superficial veins. The veins in your legs must work extra hard to push blood toward the heart. The increased blood pressure, in addition to other risk factors, causes veins to become weakened and damaged.

Most patients report feeling little, if any, pain during the Venefit™ procedure. Your physician should give you a local or regional anesthetic to numb the treatment area.

Patients report limited to no scarring, bruising or swelling following the procedure using the catheter.

The procedure has been shown in a large international, multi-center study to be 93% effective over three years.

   Pain

   Swollen legs

   Leg heaviness and fatigue

   Skin discoloration

   Ulcers

   Tired legs

Chronic Venous Insufficiency (CVI) is a progressive medical condition that may worsen over time. As varicose veins progress to become CVI, other painful symptoms like leg swelling, skin damage and ulcers may occur. There are a number of factors that contribute to varicose veins and CVI, including a history of obesity, tobacco use, previous leg injury, pregnancy, and family history of varicose veins.

The procedure is usually performed under local or regional anesthesia. It is generally performed in a vein specialist’s office or an outpatient surgical facility.

As with all medical procedures, potential risks and complications exist including vessel perforation (when the catheter punctures the vein wall), thrombosis, pulmonary embolism (when a blood clot travels to the lungs), phlebitis (inflammation of the vein), infection, nerve damage, arteriovenous fistula (an abnormal connection between an artery and a vein), hematoma (bruising), and skin burn. Consult your physician to understand the risks and benefits of the procedure.

   Relief of symptoms within 2 days

   Outpatient procedure

   Can be performed under local anesthesia

   The average patient typically resumes normal activities within a few days

   Proven results with positive patient outcomes and experience

Newer methods of delivery of radiofrequency were introduced in 2007. Endovenous procedures are far less invasive than surgery and have lower complication rates. The procedure is well tolerated by patients, and it produces good cosmetic results.

Excellent clinical results are seen at 4-5 years, and the long-term efficacy of the procedure is now known with 10 years of experience. The original radiofrequency endovenous procedure was cleared by the US Food and Drug Administration (FDA) in March 1999. Endovenous techniques (radiofrequency ablation, phlebectomy and endovenous foam sclerotherapy), clearly are less invasive and are associated with fewer complications compared with more invasive surgical procedures, with comparable or greater efficiency.

Patients treated with the procedure may resume normal activities more quickly than patients who undergo surgical vein stripping or endovenous laser ablation. With the procedure, the average patient typically resumes normal activities within a few days. (4)

For a few weeks following the treatment, your physician may recommend a regular walking regimen and suggest you refrain from very strenuous activities (like heavy lifting or prolonged periods of standing.) or prolonged periods of standing.

Only a vein specialist can tell you if the procedure is the right option for your vein problem. Experience has shown that many patients with varicose veins or CVI can be treated with the procedure.

References:

  1. LurieF, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration. (Closure procedure) versus ligation and stripping in aselected patient population (EVOLVeS Study). J Vasc Surg 2003;38;2:207-14
  2. Hinchliffe RJ, et al. A prospective randomised controlled trial of VNUS Closure versus Surgery for the treatment of recurrent long saphenous variscose veins. Eur J Vasc Endovasc Surg 2006 Feb;31;2:212-218
  3. Almeida JI, Kaufman J, Göckeritz O, et al. Radiofrequency endovenous ClosureFast versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY Study). J Vasc Interv Radiol. 2009;20:752-759.
  4. L. H. Rasmussen, M. Lawaetz, L. Bjoern, B. Vennits, A. Blemings and B. Eklof, Randomized Clinical Trial Comparing Endovenous Laser Ablation, Radiofrequency Ablation, Foam Sclerotherapy and Surgical Stripping for Great Saphenous Varicose Veins. British Journal of Surgery Society Ltd., Wiley Online Library, www.bjs.co.uk, March 15, 2011.
  5. Proebstle T. et al. Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatment of calf varicosities. JVS; July2011.

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