Yes, but what methods can we use and what guidelines should be used and will Insurance companies allow necessary follow up?
Phlebology Doctors Ask : Should we use Surgery? Foam Sclerotherapy? or Heat? When should we use compression?
Most patients need secondary treatments after ablation because of their disease process: some of the refluxing veins are too small or tortuous, they have bulging skin veins that would result in hard sclerosed coagulum after cosmetic injections and lead to matting and staining which is a real problem for patients at least in the short term of their life.
There are real needs for perforating veins to be treated if they result in unhealed ulcer patients, but most post ablation patients do not need normal perforators closed to be efficiently treated.
ONE TRIAL showed why perforators were closed:
University of Pittsburgh group (Dillavou) in a Retrospective Review, looked at 73 ulcers (avg 28 mos duration), all with perforator incompetence, w/o superficial incompetence
~ 1/3 from post deep vein thrombosis( DVT), 1/3 had Deep Vein Incompetence( Reflux)
They used STS/Poli foam + foam pads from STD pharmacy plus compression wraps
Multiple injection sessions of ultrasound guided injections into the damaged, refluxing perforating veins.
Mean follow up 30 months: 32 (52%) healed; 30 (48%) non-healed
Kiguchi M, et al. J. Vascular Surg 2014;59:1368-76
Other methods of closing perforators are with Closure Fast (RF), Varithena, and VenaSeal ( Cyanoacrylate adhesive) 2 studies below:
Cyanoacrylate adhesive was shown to be effective in a European Multi-center Trial with 70 patients because they preferred no tumescent anesthesia and no post procedure compression garments. 93% of patients were “recanalization free” at one year: Proebstle, et al JVS Vand L 2014, 2, 1: 105-106 and a VeClose study in the USA of 222 patients where they compared Radiofrequency to Cyanoacrylate adhesive and they were similar 96% vs 99% Study in JVS 2015 with Morrison, N and Gibson, K
Compression garments and compression bandages come in all shapes and sizes. Insurance companies require use of compression and other conservative treatment modalities sometimes for months before allowing surgery or endovenous procedures but they won’t often reimburse. Compression is level 1 standard of care for ulcers but with proper use may prevent these ulcers in the first place. To be continued…..
Compression stockings for prolonged sitting and standing
We will talk in future blogs more about compression but for most post op procedures (except VenaSeal glue), compression wraps, stockings, socks or elastic velcro wraps properly fitted and applied help the healing process and limit the inflammatory processes that can lead to matting, staining and phlebitis.
Come talk to us @Morrison Vein Institute 480-775-8460 Sudies compliments of Dr. Nick Morrison’s slides for lecture in 2015.
“CHRONIC VENOUS INSUFFICIENCY (CVI) is one of the most common vascular diseases in the developed world and is a major contributor to psychosocial morbidity.” And one of the worst outcomes of venous disease is leg ulcers, esp for patients over 65- up to 4% of the population! Compression bandaging is the most recognized therapy but due to lack of education of the healthcare professionals regarding application and other treatment modalities, lack of patient funds, poor insurance reimbursement for stockings and bandaging- patients suffer for at least a year or up to 10 years needlessly.
Ross K Smith and Jonathan Golledge wrote a paper ( Phlebology 2014 Vol 29 (9) 570-579) on a review of circulatory markers in CVI and their abstract and paper to follow shows providers could evaluate patients levels of estradiol, homocysteine and vascular growth factors that were most consistently associated with primary chronic venous insufficiency.
Circulatory markers studies can improve pathogenic understanding, increase prognostic understanding and enhance diagnostic and treatment modalities.
Early recognition of vein disease with comprehensive diagnostic evaluation and in-office minimally invasive vein treatments: revolutionary glue ablations, radiofrequency or laser ablations and ultrasound guided chemical ablations of ” faulty valve- diseased” saphenous veins, accessory veins, pudendal veins, and even pelvic vein disorders can prevent the road to leg ulcers, DVTs, and varicose vein disease disorders.
Schedule a vein screening and learn about vein disease from Morrison Vein Institute.
We have been dedicated to vein disease for 20 years.
No, not really. There are men who have discovered that their legs feel better when they wear something that supports their legs. Venous insufficiency is more common in women, but men experience it too.
Venous insufficiency can cause symptoms such as achy legs, tired heavy feelings, leg cramps, (those excruciating Charlie horses in the middle of the night!) swelling, restless legs, and itching. We have had patients who have scratched their legs raw due to severe itching. Many patients who have itching think they just have dry skin. If lotions and potions don’t help the itching – think again.
So, support hose, for men? Yes! All of our treatments require wearing support hose for 3 weeks after each treatment, even if the treatment is injecting spider veins. But, we suspect that at least some of our mil patients end up wearing them longer – for the comfort and symptom relief they provide. Or, maybe they go out and buy those supermarket brands of support hose to wear. We do recommend all of our patients who have venous insufficiency wear at least lighter weight support hose (such as 15-20 mmHg to 18-25 mmHg, or 20-30 mmHg) on an ongoing basis.
According to The Wall Street Journal, some men wear pantyhose for extra warmth (likely not in Arizona!) as well as support. Remember, European aristocracy wore such garments – look at the portraits of royalty 200+ years ago!
Come for a free screening, call today 480-775-8460
Great to see compression hose mentioned in blogs about travel and style. The author says “…recently realized need to wear compression hose on long flights [something I have done for years either to board or put on once airborne]. There is absolutely no reason safety and comfort must replace style … being fashionable always an option if only effort and thought given the matter. Why even my compression hose come in sexy lace topped thigh highs.”
In Jane Austen’s iconic book, “Sense and Sensibility” the main theme is how the family central and the women characters prevalence of excessive sensibility renders them without venue to betterment in their life fraught with difficulties. How connected to ones travel attire you ask? Well actually quite a easy analogy … far too often attempts at what some claim as “sensible” is no more than what is most readily available and as such in no need of forethought or planning. Frequently these choices render wearer as uncomfortable as they appear untidy and unattractive – this too leaving one expending energy in defense of being assured their choice was perfect. The options are plentiful and should include practicality, protection and good taste – difficult you might be thinking to combine all these into a single travel attire choice. No dear readers – it just takes…
Terri Morrison, co-founder of Morrison Vein Institute, was asked by The American College of Phlebology to teach a nursing course in California this month. Nurses from all around the nation came to learn about treating veins with sclerotherapy and compression. Terri was teaching the course with several other experts in the field of Phlebology, which is the study of veins and vein disease. The course was a huge success and Terri was thankful she was asked to be a part of it.
Did you know that compression stockings come in colors? And leggings? Yes, compression stockings come in all sorts of colors and styles, even tie dyed leggings. No more ugly ted hose or granny hose. Now all of these colorful compression hose come in knee highs, thigh highs, panty hose and leggings. Check out our fashionable staff below wearing colorful compression stockings!
Tie-dye is back! Check out the new colors of compression stockings, including tie dye, that we offer to our patients thru All About Compression, Inc. They come in open toe, closed-toe, thigh highs, panty hose and leggings! We are always promoting health legs at Morrison Vein Institute, and we like fashion too. No more waiting to get your veins done because of the granny-style hose you have to wear. Now you can be in-style and help your legs too! Call All About Compression to order your stockings today and they can ship them to your house 855-835-3544
Leggings are in!!! We see them everywhere now, and soon knee highs will be in style in the US as they are already a fad in Europe(see picture above). Compression hosiery companies have to keep up with the latest fashion to stay in business, so they have come up with colored leggings, thigh-highs and panty hose that have compression in them, as seen in photos below.
Now your legs can feel great and you can be in-style too! We sell every color imaginable and several styles of compression stockings at Morrison Vein Institute.
Check out our newest compression stocking colors at Morrison Vein Institute! They come in thigh highs, panty hose and leggings! Now you can be fashionable while maintaining your leg health too! Call (866) GRT-LEGS (5347) to find out more or check out http://www.morrisonvein.com