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.
Klippel-Trenaunay A rare and genetic syndrome that is often the most severe
manifestations of varicose vein disease. The syndrome is a vascular disorder
that consists of abnormalities in the venous system, lymphatic system, and
arterial systems. This disorder often manifests itself in the form of
varicose veins, arterio-venous malformations (AVMs), lymphedema, port-wine stains
and eventually limb hypertrophy (enlargement of the involved extremity).
Treatments may be an option for patients after a specific workup.
Face veins and hand veins can be more than cosmetic; you want a vein care
specialist called a phlebologist with lots of experience to care for you.
Call us for a vein screening and then a workup for a specially
designed treatment plan. 480-775-8460. #Morrisonvein www.morrisonvein.com
Hereditary risk factors for vein disease such as family history of veins combined with age, sedentary lifestyle, prolonged sitting or standing, and increased BMI, cigarette smoking, and pregnancies, all add to our chances of varicose and spider veins. The venous circulation is supposed to go up the legs back to the heart as the diagram above depicts. But with reflux, venous disease called venous insufficiency, the blood goes down the wrong way causing blood pooling and a cascade of events over time.
50% of women by the time they are 50 years old can have vein disease and 25% of men and this goes up 10% a decade. So with early intervention of easy in office vein venous ultrasound scan for a diagnosis and vein map, vein treatments there is a way ti minimize our disease process. Combine this with exercise, leg elevation, calf muscle pump exercises and good medical compression socks or stockings, we can minimize detrimental effects of varicose veins and their symptoms and complications: skin changes, restless legs, leg swelling, cramping, heaviness, feet ” burning” sensation, vulvar varicosities, deep vein thrombosis, thrombophlebitis, itching, and of course surface veins.
Come talk to us, see an informational video, get measured for compression socks and plan for healthier legs. 480-775-8460 Tempe, Scottsdale email@example.com for questions. We look forward to seeing you.
One of our Morrison Vein Institute patients said I should put an ad that says: ” Do you have time on your hands?” As we age, our skin gets thinner with loss of collagen and elastin, so we notice our hand veins more. Also when our body fat content is low, there is no padding to hide our veins. Then some women get age spots as well and want to just cover up the whole thing?!? We can take on thing at a time. Treat the veins with sclerotherapy 2-3 sessions, then have a plastic surgeon or dermatologist help correct the age spots and use fillers or fat transplants to make the hands look more youthful. Lets plan it out. Call Morrison Vein: 480-775-8460
Amigos de Salud, Inc. is a non profit, 501 C3 organization founded by Dr. And Mrs. Nick Morrison, MD. Nick and Terri, co-founders of Morrison Vein Institute, have organized and accompanied teams of volunteer medical groups to Central and South America for over 25 years. These last 2 years, world-renown vein doctors from Italy have joined us to care for over 1000 indigent poor every year in a weeks time. We thank our donors who have donated medical compression stockings, bandages, and medical supplies to make this effort possible. We are also thankful to our nurses, doctors and volunteer team for donating their time, talents and money to support this effort. Thank you to Fara Foundation in Nicaragua for their gigantic effort and support as well.
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.
Dr. Morrison has organized a “meeting of the minds” for the last several years in Arizona for the worlds-best vein specialists. They are all here this weekend discussing treatments for varicose veins, the practice of Phlebology, compression therapy for veins, wound care, and all the ways to improve the diagnosis and treatment of vein disease. Experts traveled from around the US, Europe and South America to be a part of this very special invitation-only medical conference, which focuses not on a series of lectures, but of scientific topics presented and discussed. This structure allows for in-depth discussion of phlebology. This year’s meeting was sponsored by an unconditional education grant from MediUSA. Some of the presenters, world-renowned physicians, and invited guests include, Lars Rasmussen, Giovanni Mosti, Felizitas Pannier, Tom Wakefield, Allesandro Pieri, Jonathon Wanderer, Diana Neuhardt, Hugo Partsch, Dean Bender, Eric Mowatt-Larssen, Nick Morrison, Steven Zimmet, Joseph Caprini, Joe Zygmunt, Stephen Daugherty, Mark Forrestal, Dermott Moore, Mark Meissner, Helane Fronek, and many other brilliant minds. They got to have a little fun too, as shown in the pictures below.
The staff at Morrison Vein Institute and Compudiagnostics formed a team for the Annual LoziLu MudRun in Arizona last year. They participated again this year and had shirts made with their team The Veinanators. They also wore yellow and black tie dye compression stockings to promote leg health at the event. Check out some of the pictures from this years event.
Morrison Vein Institute is teaming up with a well-respected plastic surgeon, Dr Jeffrey Ptak, next Thursday May 30th for a Health and Beauty Soiree! Come learn about leg health, vein disease, beauty secrets, and the latest procedures for your whole body! Seats are limited, so click on the link below to RSVP today or you can call us 480-860-6455 and say you want to be added to the list for the open house.