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How are varicose veins evaluated?

A Plan Designed To Fit Your Needs

To ensure you receive the highest level of care and long-term results, Carolina Vascular has established an algorithm that allows our doctor to evaluate, diagnose, treat, and follow-up on your vein condition. Our comprehensive system assures you will receive the most advanced treatments for your varicose veins and spider veins and that you will have an excellent understanding of the process.

STEP 1: Initial Consultation with Dr. Clark or Dr. Kagan

During this visit, we obtain a thorough history regarding your vein symptoms and perform a thorough vascular physical examination.

A duplex ultrasound will be performed for a complete, more in-depth evaluation of the venous system.

Most insurance companies cover the treatment of vein disease (and varicose veins) if there are significant symptoms. Typically, however, insurance companies require three to six months of conservative therapy with compression stockings prior to treatment. If you have significant symptoms or skin changes and varicose veins are identified, we will then request authorization for treatment from your insurance company to get that process started as early as possible for you.

We also perform cosmetic vein procedures.

STEP 2: Diagnostic Ultrasound Imaging

An ultrasound of the superficial and deep venous system is necessary to rule out superficial or deep vein blood clot and to document sources of reflux (back flow of blood that causes varicose veins). The study is performed by a Registered Vascular Technologist with several years of experience in the evaluation of venous disorders. The test will be interpreted by Dr. Clark or Dr. Kagan who will personally give you the results that very same day.

The study is painless, usually takes approximately 20-30 minutes and the majority of the study is performed while you are standing in order to obtain the best assessment of the varicose veins.

STEP 3: Education and Treatment Plan Discussion

Following the initial consultation and ultrasound, all findings will be summarized and explained, and a treatment plan will be discussed with you. If you have varicose veins and they meet your insurance company’s criteria for treatment, a period of conservative therapy will be initiated, unless you have already been wearing compression hose. Although varicose vein treatment may be appropriate, many insurance carriers require you to meet strict guidelines to be eligible for reimbursement. If your ultrasound is normal, you may schedule a cosmetic sclerotherapy treatment. If you chose not to utilize insurance benefits for payment, treatment can begin immediately.

STEP 4: Endovenous Ablation

Endovenous Laser Ablation (EVLT) is the primary therapy used by Carolina Vascular for the treatment of saphenous vein disease. The 30-minute procedure is performed in our office under local anesthesia. Patients are typically “in-and-out” and resume usual activities upon leaving the office. Our new 1470 nm laser leads to less discomfort, less bruising and fewer complications than with other forms of therapy.

STEP 5: Ultrasound Guided Sclerotherapy

Additional procedures (such as sclerotherapy) may be required to complete treatment of the varicose vein branches. This 15-minute procedure is generally performed 4-6 weeks following a venous ablation and multiple sessions may be necessary to complete your treatment.

STEP 6: Post-Treatment Evaluation

During your post-treatment evaluation, we will again use an ultrasound to evaluate the treated veins and determine if additional procedures are needed. Once your varicose veins have been successfully treated, you can begin treatment for your spider veins. It is important to treat the underlying varicose veins first.

Varicose veins are controlled, not cured. It is important to have periodic follow-up evaluations to maintain healthy legs!

All procedures are performed by a Board Certified Vascular Surgeon. We are dedicated to helping each of our patients enjoy a healthy, active lifestyle free from the detrimental effects of varicose veins and venous disorders.