Frequently Asked Questions Q: Is the Venefit™ Procedure painful? A : Patients report feeling little, if any, pain during and after the procedure. And many patients notice an immediate relief of pre-procedure symptoms such as pain, leg heaviness and fatigue. Q: Are the procedures covered by my insurance? A : Most major health insurers cover the Venefit procedure. Sclerotherapy and laser treatments are considered cosmetic procedures. They are not generally covered by insurance unless there is a cosmetic rider. Q: What factors increase my risk of varicose veins and spider veins? A : Increased age as you get older, the valves of the veins may weaken and not work as well. Some people are born with weak vein valves which increase your risk. During hormonal changes and pregnancy, increase of blood in the body causes damage to veins. Q: Will I require Sclerotherapy and laser treatment for spider veins? A : In many cases, to insure the best outcome sclerotherapy is often recommended to treat the feeding reticular veins first. Then a few weeks later the laser treatment can be performed to complete the process. Dr. Julio A Alvarez, MD, FACS Dr. Daniel Leary, MD, FACS Vascular Associates of WNY is committed to providing you the peace-of-mind in knowing you have selected the premier team in Vascular Surgery. Dr. Julio A Alvarez, MD, FACS and Dr. Daniel Leary, MD, FACS have over 50 years of combined experience in Vascular and Endovascular Procedures. Covering all aspects of Vascular Surgery including Carotid Endarterectomy, AAA Repair, Lower Extremity Bypass Grafting, Minimally Invasive Repair of Blocked Arteries and Venous Closure for Venous Insufficiency. Our facility is equipped with state-of –the-art ultrasound equipment to preform vascular studies; arterial and venous. Q: Are spider veins dangerous? A : Spider veins are rarely a serious health problem, but they can cause uncomfortable feelings in the legs. They can cause itching and burning. Q: How long will I be out of work for any of the procedures? A : Typically patients may return to work the same day as sclerotherapy and laser treatments. Patients may return to work the day following Venefit™ procedure. Julio A. Alvarez M.D., F.A.C.S. Daniel A. Leary III, M.D., F.A.C.S. Joseph Gerbasi M.D., F.A.C.S. Natalie A. Passmore, ANP-C Vascular Associates of WNY 3030 Orchard Park Road, Suite B Orchard Park, NY 14127 TEL 716-671-8393 • FAX 716-671-8398 WEB www.wnyvascularhealth.com Treatment & Procedures for Chronic Venous Insufficiency, Varicose Veins & Spider Veins Symptomatic Venous Disorders The Venefit™ Procedure Millions of patients suffer from cosmetically disfiguring leg veins and Symptomatic Venous Disorders. About 50-55% of women and 40-45% of men in the United States suffer from some type of vein problem. The same disease process can affect veins of any size: however when larger veins fail, they are typically called varicose veins. When smaller veins are affected, they are typically called spider veins. Chronic Venous Insufficiency (CVI) is a progressive medical condition that worsens over time and affects the veins and vessels in the leg that carry oxygen-poor blood back toward the heart. Varicose veins, which are enlarged veins in the leg that appear like twisted, bulging cords, can progress to CVI if they remain untreated. The Venefit™ procedure is a minimally invasive treatment for varicose veins and Chronic Venous Insufficiency (CVI) in which a physician will insert the catheter into the diseased vein, through a tiny opening in the skin. The tiny catheter delivers radio frequency (RF) energy to the vein wall. As the RF energy is delivered and the catheter is withdrawn the vein wall is heated, causing the collagen in the wall to shrink and the vein to close. Once the diseased vein is closed the blood is re-routed to other healthy veins. Unlike painful vein stripping surgery or laser ablation, the catheter delivers uniform, consistent heat to each segment. As a result, the Venefit™ procedure causes less bruising and allows for rapid patient relief and recovery. The Venefit™ procedure is commonly performed in an office or an outpatient setting and is covered by most health insurance in the United States. The Venefit™ procedure eliminates the need for groin surgery and general anesthesia. The procedure also results in little to no scarring and is generally performed using local anesthesia in the office setting. Patients will typically resume normal activity within a day. Healthy Vein Valve Diseased Vein Valve Healthy leg veins are designed to allow blood to flow against gravity from the legs back up toward the heart. Inside the veins are tiny valves that open and close to help control the flow and pressure. CVI occurs when stresses on the venous system like pregnancy, age or standing for long periods of time weaken and stretch the vein structure. When the veins become weakened or diseased, the blood flow is obstructed and blood pools in the legs. This impaired blood flow (or reflux) causes veins to expand, lose form and protrude from beneath the skin. Chronic Venous Insufficiency Symptoms Of the over 30 million Americans affected by varicose veins or CVI, only 1.9 million seek treatment annually, while the vast majority remain undiagnosed and untreated. Without treatment, those with the disease may experience progressive symptoms that can be debilitating and significantly impact quality of life. In fact, more people lose work time over vein disorders than from artery disease. Those who suffer from CVI may experience: • Leg heaviness and fatigue • Leg or ankle swelling • Leg pain, aching or cramping • Skin changes • Ulcers, open wounds or sores Venefit™ Radio Frequency Procedure Before After Stab Phlebectomy Stab Phlebectomy is an additional method of surgical removal of varicose veins at the surface of the skin. Small incisions are made next to the vein and sections of the vein are removed through these small nicks. This procedure is frequently done in the office setting using local anesthesia. Normal activities may be resumed after a few days. A decision by the physician will be made during your evaluation as to which procedure would be most beneficial. Reticular Vein & Spider Vein Sclerotherapy Treatments Before After Reticular Vein & Spider Vein Treatment Reticular Veins are formed by larger veins that are located deeper in the skin surface. They are usually blue or purple in color, and frequently feed areas of spider veins which are closer to the surface. The reticular veins are usually about 2mm in diameter and often do not protrude. They may form unattractive clusters of veins predominately located on the inner part of the thighs, backs of the legs and ankles. They can cause symptoms of pain and discomfort. Sclerotherapy is often used to treat reticular veins and spider veins. Sclerotherapy involves injecting a sclerosing agent into the vein. The agent damages the wall of the vein, causing the vein to collapse on itself, seal shut and then is reabsorbed by the body. Individual results may vary, and many patients may require multiple injections for complete treatment success. A typical session lasts 15-45 minutes; one injection is usually administered per inch with multiple injections per session. Spider veins are closer to the surface of the skin than varicose veins. They are often red or blue, they can look like tree branches or spider webs with their short jagged lines. They can be found on the legs and on the face and can cover either a small or very large area of skin. Spider veins can be caused by a backup of blood, hormonal changes, exposure to the sun and injuries. Laser treatment can effectively treat spider veins. The technique sends a very strong burst of light through the skin into the vein. This makes the veins slowly fade and disappear. Not all skin types and colors can be safely treated with lasers. No needles or incisions are used but the heat from the laser can be uncomfortable. Cooling with ice helps. Treatments usually last between 15 to 60 minutes. Generally 2-5 treatments are needed to remove spider veins in the legs