Visual Sclerotherapy. 1:24-1:36 Now 10 minutes flying along. Nick Morrison, MD, FACPh, FACS President, International Union of Phlebology
|
|
- Kenneth Bryan
- 5 years ago
- Views:
Transcription
1 1:24-1:36 Now 10 minutes flying along Visual Sclerotherapy Nick Morrison, MD, FACPh, FACS President, International Union of Phlebology Sedona, Arizona
2 Canyon de Chelly, Airzona Disclosures Educational Grant, Speakers Bureau mediusa Consultant Merz SAB, Research Grant Speakers Bureau Medtronic Speakers Bureau Pierre-Fabre Speakers Bureau Craveri Medical Director Morrison Vein/Training Institute
3 Disclosures Off label and/or Non-FDA Approved Drugs Polidocanol and STS foam, as referred to in this presentation, may be considered off-label or unapproved by the FDA
4 Key Steps in Sclerotherapy Evaluation and Assessment Photo documentation Patient Education Sclerosant choice Injection Techniques Post-Injection care Follow-up visits
5 Evaluation and Assessment Medical vs Cosmetic Determine if patients are medical or cosmetic in the early screening process If medical, need further study (duplex) If patients meet the medical criteria, the underlying medical process must be treated first, before the surface veins, for better outcome
6 Photographic Documentation Photographic documentation is important for both the physician and patient in order to document the results and efficacy of therapy. a) This helps assure the patient about the progress of treatment b) May be required by the insurance carrier c) Is helpful for legal documentation
7 Patient Education Establish Realistic Expectations!! No "Quick Fix": most pt's require a minimum of 2-5 sessions approx. 4-6 weeks apart Legs will ALWAYS look worse before they look better.
8 Establish Realistic Expectations Pt's with significant/severe symptoms often begin to notice a favorable improvement in how legs feel and possible resolution of many symptoms before they will see changes of the appearance. There currently is no known cure for venous disease: pt's will develop more spider veins as they get older and/or will also continue to develop refluxing veins as well.
9 Financial Planning Full Disclosure Patient costs sheet Insurance coverage Deductible met? Co-Pay Out-of-Network Non-covered procedures Denial appeals Medical Necessity requirements
10 Sclerosants Choose the appropriate sclerosant and strength of sclerosant Minimum volume and concentration to cause sufficient endothelial damage Looking for the perfect sclerosant? : Painless, non-allergenic, effective for all veins, inexpensive, FDA approved, no matting, no ulcerations, no staining, locally available IT DOES NOT EXIST!
11 Foam Sclerosants Any detergent can be foamed Foaming increases effectiveness by increasing the surface area of the solution on the vein wall and displacing the blood for a longer time Foam is not commonly indicated for use on veins < 2 mm Sometimes used for reticular veins or veins using ultrasoundguidance; not for small diameter spider veins
12 Injection Techniques Aspiration- gentle aspiration of blood into the needle hub to assure placement Puncture Feel The feel of perforating the vein wall can be mastered with experience Empty Vein- emptying blood by elevation prior to injection to assure contact with the endothelial surface; generally for larger veins
13 Injection Techniques Basic Principles Opinions Treat Proximal to distal Treat larger to smaller vessels Treat reticular and spider veins in each area Apply local compression immediately following injection Ambulation should occur immediately following treatment
14 Correct Sclerotherapy Position Ergonomically comfortable for sclerotherapist and patient
15 Cutaneous Sclerotherapy
16 STS Protocol < 3mm veins % liquid solution >3mm veins.5 % - 3 % liquid or foam Maximum dosage recommendation not to exceed 10 ml per treatment session
17 Polidocanol Protocol < 3mm veins-.5 %-1% liquid solution >3mm veins 1% liquid or foam (That s all that is FDA-approved and available) Maximum dosage recommendation not to exceed 10 ml per treatment session
18 Foam Sclerotherapy for telangiectasias/reticular veins notes of caution NOT for beginners works well but very strong technically difficult to manage dripping obscures target veins must inject quickly after foam production Neurosensory complications increased
19 Injection Techniques Basic Principles Opinions Bend needle to 15-30% angle to enable cannulation of small superficial veins Stretch skin taut Brisk cannulation of the vein reduces vascular trauma, vasoconstriction and chance of extravasation Maintain low injection pressure to prevent vascular distention Inject small amounts of solution at each site to help prevent matting and extravasation Inject at appropriate intervals until the entire vessel has been treated
20 Post Injection Care Patients walk immediately after each treatment session Treatment sessions are carried out at 4-6 week intervals to allow enough time to evaluate the results of the prior treatment Most patients will require 2-5 treatments
21 Post Injection Care Graduated Support Hose Reduces risk of DVT post treatment Reduces incidence of microthrombi* Objective outcome measurement improved* Helps alleviate pt. symptoms and contributes to vein sclerosis *Kern, et al. J Vasc Surg 2007;45:
22 Post Injection Care Compression Pearls Spot compression may be applied over injection sites with cotton and micro pore tape or beveled compression pads (STD, Hereford, England) may be applied. Compression pads are particularly helpful when treating bulging vessels and for patients who bruise easily.
23 Follow up Visits: Evaluation for Complications Complications of sclerotherapy can be minimized by proper patient selection, accurate examination to r/o medical vs. cosmetic, appropriate sclerosant choice, and use localized compression post treatment
24 Follow up Visits: Evaluation for Complications Microthrombi (trapped blood) Bruising Itching Cramping Hyperpigmentation Telangectatic matting Ulceration Scarring Phlebitis DVT
25 Microthrombi Blood may become trapped in a partially closed vein Presents as a dark bruise or sliver like appearance Should be evacuated using topical and/ or local anesthetic and an 18 ga. Needle Contributes to hyperpigmentation May be palpable and tender to touch Best to wait 7-10 days post sclerotherapy to evacuate If accompanied by inflammation, pre-treat the pt. with anti-inflammatory meds and compression to minimize discomfort and for hrs post aspiration
26 Follow up Visits: Evaluation for Complications Hyperpigmentation Most common side effect, occurring in 10-30% of patients Brown discoloration along the vessel due to hemosiderin staining from trapped blood Rarely occurs in veins < 1 mm Spontaneous clearing in 6-12 months TIME
27 Follow up Visits: Evaluation for Complications Telangiectatic matting Matting or blushing may occur in 15% of post-sclerotherapy treatments Tiny red spider veins that appear like a blue or red bruise Possible causes are too high sclerosant strength, too much pressure and or volume when injecting
28 Follow up Visits: Evaluation for Complications Telangiectatic matting Look for hidden reticular veins visually or by ultrasound that are contributing Laser therapy may be used: 585nm pulse dye, 532 or 1064 long pulse, IPL
29 Follow up Visits: Evaluation for Complications Ulceration More common with Hypertonic saline, but can occur with other sclerosants Common on the anterior tibial or malleolar area Probably caused by injection into an arteriole or pressure greater than capillary pressure with reversed flow into arteriole
30 Follow up Visits: Evaluation for Complications Ulceration Increase risk with elderly, anorexics, smokers Minimize risk with proper concentrations, appropriate pressure, attention to risk areas Treat with occlusive wound dressing and care Will persist for 2-4 months, leaves a scar
31 Follow up Visits: Evaluation for Complications DVT Rare but not never Requires Standard Workup Compression Ambulation Anti-inflammatory
32 Embolia Cutis Medicamentosa (Nicolau s syndrome) 28 March, October, 2006
33 Follow up Visits: Evaluation for Complications Unusual complication Embolia cutis medicomentosa Prevention: Low volume/pressure injections Treatment: Local wound care Analgesics, sleeping aids (lesion painful) Time many will resolve over several weeks to months with minimal scarring and without full thickness tissue loss Others, on the other hand.
34 Compounded Drugs Contamination NECC* About 2,330,000 results (0.20 seconds) Steroid Injection Lawsuit 1 (866) Pulaski & Middleman Law Firm Will Fight For Your Case. Call Us Today! *Search: November 11, 2012
35 Compounded STS Product ph % Carbitol % Sotradecol % CAP % McGuff % Kronos % Almeida JI, Raines JK. FDA-approved sodium tetradecyl sulfate (STS) versus compounded STS for venous sclerotherapy. Dermatol Surg 2007; 33:
36 Compounding-Physician Liability If a physician chooses to use a compounded drug AND A connection can be made between injury and the drug THEN The physician is liable PERIOD!
37 Compounded Drug Use Conclusion AVOID DISASTER
38 Conclusions Sclerotherapy, when properly administered, is a safe and effective method of eliminating abnormal veins Complications can be reduced by careful attention to technique Sclerotherapy is an often necessary and desirable complement to other invasive treatment of chronic venous insufficiency
39 39
40 Thank you very much for your kind attention
Patient Information. Venous Insufficiency and Varicose Veins
Patient Information Venous Insufficiency and Varicose Veins What is a Varicose Vein? Gitter Vein Institute-revised 3/8/2016 2 Frequently Asked Questions What is the difference between varicose and spider
More informationVaricose Veins What Are They? Sclerotherapy in the Treatment of Venous Disease Zachary C. Schmittling, MD, FACS May 4, 2018
Sclerotherapy in the Treatment of Venous Disease Zachary C. Schmittling, MD, FACS May 4, 2018 Sclerotherapy for Venous Disease: Overview 1 in 5 Americans Approximately 25% of women have some type of lower
More informationThis information is intended as a general guide only. Please ask if you have any questions relating to this information.
Foam Sclerotherapy (Varicose vein injections) Vascular Surgery This information is intended as a general guide only. Please ask if you have any questions relating to this information. Varicose Veins Veins
More informationNon-Saphenous Vein Treatments. Jessica Ochs PA-C Albert Vein Institute Colorado Springs and Lone Tree, CO
Non-Saphenous Vein Treatments Jessica Ochs PA-C Albert Vein Institute Colorado Springs and Lone Tree, CO I have no financial disclosures Types of Veins Treated Perforator Veins Tributary Veins Varicose
More information[Kreussler Studies] FDA. multicenter GCP. controlled. randomized. prospective. blinded SUMMARY OF PIVOTAL STUDIES ON SCLEROTHERAPY OF VARICOSE VEINS
[Kreussler Studies] SUMMARY OF PIVOTAL STUDIES ON SCLEROTHERAPY OF VARICOSE VEINS FDA randomized controlled GCP blinded prospective multicenter [Sclerotherapy of Varices] Healthy legs with microfoam Chemische
More informationPOLIDOCANOL VS STS FOR SPIDER VEINS. Steven E. Zimmet, MD RPVI RVT FACPh
POLIDOCANOL VS STS FOR SPIDER VEINS Steven E. Zimmet, MD RPVI RVT FACPh Disclosures/COI No COI Off-label use Lipid bilayer with membrane proteins Lipid bilayers are the basic structures that make up cell
More informationDisclosure. Lowell Kabnick, M.D., FACS, FACPh. I disclose the following financial relationship(s):
Disclosure Lowell Kabnick, M.D., FACS, FACPh I disclose the following financial relationship(s): Research Grant: BTG; Ownership Interest: AngioDynamics, Vascular Insights; Consultant/Advisory Board: AngioDynamics,
More informationChronic Venous Insufficiency Compression and Beyond
Disclosure of Conflict of Interest Chronic Venous Insufficiency Compression and Beyond Shawn Amyot, MD, CCFP Fellow of the Canadian Society of Phlebology Ottawa Vein Centre I do not have relevant financial
More informationLove your legs again Varicose Veins
Love your legs again Varicose Veins Veins are the vessels that return blood to the heart once it has circulated through the body (as opposed to arteries, which carry oxygen-rich blood from the heart to
More informationLast literature review version 19.3: Fri Sep 30 00:00:00 GMT 2011 This topic last updated: Thu Sep 30 00:00:00 GMT 2010 (More)
19.3 Liquid and foam sclerotherapy techniques for the treatment of lower extremity veins Authors Deborah L Greenberg, MD, FACP Sherry Scovell, MD, FACS Section Editors John F Eidt, MD Joseph L Mills, Sr,
More informationAppendix 1 to Direct Vision Sclerotherapy AUSTRALASIAN COLLEGE OF PHLEBOLOGY CLINICAL PROCEDURES. CP Direct Vision Sclerotherapy Clinical procedure
Appendix 1 to Direct Vision Sclerotherapy AUSTRALASIAN COLLEGE OF PHLEBOLOGY CLINICAL PROCEDURES CP Direct Vision Sclerotherapy Clinical procedure 1 PURPOSE This procedure summarises the actions required
More informationWhich place for liquid sclerotherapy? Eberhard Rabe Department of Dermatology University of Bonn Germany
Which place for liquid sclerotherapy? Eberhard Rabe Department of Dermatology University of Bonn Germany Liquid Foam or GSV, foam / liquid sclerosant n diameter[mm] Follow up effectivity Hamel Desnos 2003
More informationMOCA and GLUE: results and analyses of the RCTs
MOCA and GLUE: results and analyses of the RCTs Faculty disclosure Research Grant Medtronic Educational Grant mediusa Speakers Bureau Medtronic Pierre Fabre mediusa Medical Director Morrison Vein/Training
More informationAmbulatory Phlebectomy & Sclerotherapy. Dr. S. Kundu Medical Director The Vein Institute of Toronto
Ambulatory Phlebectomy & Sclerotherapy Dr. S. Kundu Medical Director The Vein Institute of Toronto 1 Disclosures Consultant: Bard Canada Boston Scientific Canada Edwards Life Sciences Baylis Canada Sigmacon
More informationHow varicose veins occur
Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs, anywhere from groin to ankle. Spider veins are smaller, flatter, red or purple veins closer
More informationClinical comparison of sodium tetradecyl sulfate 0.25% versus polidocanol 0.75% in sclerotherapy of lower extremity telangiectasia
ORIGINAL ARTICLE Clinical comparison of sodium tetradecyl sulfate 0.25% versus polidocanol 0.75% in sclerotherapy of lower extremity telangiectasia Wafaa M Ramadan, MD, Khaled H El-Hoshy, MD, Dalia M Shaaban,
More informationV I U R E V I E W. T h e O f f i c i a l J o u r n a l o f V e n o u s I n s u f f i c i e n c y U n i v e r s i t y
C o m p l i m e n t s o f S a n j i v L a k h a n p a l, M D, J a i m e M a r q u e z, M D, J e r r i l y n J u t t o n, M D, K e l l y O ' D o n n e l l, M D, R a j i v J h a v e r i, M D, L u i s A.
More informationVaricose Vein Information Sheet
Neil Goldstein, MD Joseph Hewett, MD Board- Certified Physicians in Interventional, Diagnostic, and Vascular Radiology, Surgery, Vascular Surgery and Phlebology Varicose Vein Information Sheet PREVALENCE
More informationWHAT ABOUT FOAM SCLEROTHERAPY IN REVAS? Dr O CRETON Ste FOY LES LYON
WHAT ABOUT FOAM SCLEROTHERAPY IN REVAS? Dr O CRETON Ste FOY LES LYON Disclosure of Interest I have the following potential conflicts of interest to report: Consulting: Medtronic WHAT ABOUT REVAS? Source
More informationPROVIDER POLICIES & PROCEDURES
PROVIDER POLICIES & PROCEDURES TREATMENT OF VARICOSE VEINS OF THE LOWER EXTREMITIES STAB PHLEBECTOMY AND SCLEROTHERAPY TREATMENT The primary purpose of this document is to assist providers enrolled in
More informationAdditional Information S-55
Additional Information S-55 Network providers are encouraged, but not required to participate in the on-line American Venous Forum Registry (AVR) - The First National Registry for the Treatment of Varicose
More informationDate: A. Venous Health History Form. Patient please complete questions Primary Care Physician:
E S Insurance: 2 nd Insurance: Wait time: Date: A. Venous Health History Form Patient please complete questions 1-12 Patient Name: SSN#: Date of Birth: Primary Care Physician: What is the reason for your
More informationDisclosures. What is a Specialty Vein Clinic? Prevalence of Venous Disease. Management of Venous Disease: an evidence based approach.
Management of Venous Disease: an evidence based approach Disclosures Ed Boyle, MD Andrew Jones, MD Dr. Ed Boyle and Dr. Andrew Jones disclose Grants/research support: Medtronic, BTG International, Clearflow,
More informationDate: A. Venous Health History Form. Patient please complete questions Primary Care Physician:
E S Insurance: 2 nd Insurance: Wait time: Date: A. Venous Health History Form Patient please complete questions 1-12 Patient Name: SSN#: Date of Birth: Primary Care Physician: What is the reason for your
More informationSclerotherapy: treatment for thread veins on the legs
Sclerotherapy: treatment for thread veins on the legs What causes thread veins and varicose veins? 50% of the population will develop problems with their leg veins during their life. In most cases there
More informationMedicare C/D Medical Coverage Policy
Varicose Vein Treatment Medicare C/D Medical Coverage Policy Origination Date: June 1, 1993 Review Date: February 15, 2017 Next Review: February, 2019 DESCRIPTION OF PROCEDURE OR SERVICE Varicose veins
More informationGraduated compression stockings are universally
Efficacy of Graduated Compression Stockings for an Additional 3 Weeks after Sclerotherapy Treatment of Reticular and Telangiectatic Leg Veins PAVAN K. NOOTHETI, MD, KRISTIAN M. CADAG, BS, ANGELA MAGPANTAY,
More informationHealthy Never Looked So Good. At the forefront of the latest solutions in vein treatment.
Healthy Never Looked So Good. At the forefront of the latest solutions in vein treatment. The Vein Institute team of secretaries, technicians, nurses, and Dr. Alex Afshar treated my vein issues with care
More informationSCLEROTHERAPY. Cosmetic purposes to improve the appearance of varicose and spider veins
SCLEROTHERAPY Sclerotherapy effectively treats varicose and spider veins. It's often considered the treatment of choice for small varicose veins. Sclerotherapy involves injecting a solution directly into
More informationEpidemiology: Prevalence
Epidemiology: Prevalence More than 30 million Americans suffer from varicose veins or a more serious form of venous disease called Chronic Venous Insufficiency (CVI). 1 Of the over 30 million Americans
More informationVein Disease Treatment
MP9241 Covered Service: Yes when meets criteria below Prior Authorization Required: Yes as indicated in 2.0, 3.0, 4.0 and 5.0 Additional Information: None Prevea360 Health Plan Medical Policy: Vein disease
More informationExpanding Your Vein Business Terri Morrison, RN, B.S., CEO Morrison Vein Institute Scottsdale/Tempe Arizona
Expanding Your Vein Business Terri Morrison, RN, B.S., CEO Morrison Vein Institute Scottsdale/Tempe Arizona March 8, 2011 Varicose Vi Vein Market Approximately 40% of the US population has venous disease;
More informationEvaluation of lidocaine as an analgesic when added to hypertonic saline for sclerotherapy
Evaluation of lidocaine as an analgesic when added to hypertonic saline for sclerotherapy Rizwan H. Bukhari, MD, Joann M. Lohr, MD, Douglas S. Paget, MD, Andrew T. Hearn, MD, and Robert D. Cranley, MD,
More informationV I U R E V I E W. T h e O f f i c i a l J o u r n a l o f V e n o u s I n s u f f i c i e n c y U n i v e r s i t y
C o m p l i m e n t s o f S a n j i v L a k h a n p a l, M D, J a i m e M a r q u e z, M D, J e r r i l y n J u t t o n, M D, K e l l y O ' D o n n e l l, M D, R a j i v J h a v e r i, M D, L u i s A.
More informationPriorities Forum Statement
Priorities Forum Statement Number 9 Subject Varicose Vein Surgery Date of decision September 2014 Date refreshed March 2017 Date of review September 2018 Relevant OPCS codes: L841-46, L848-49, L851-53,
More informationFIND RELIEF FROM VARICOSE VEINS. VenaSeal Closure System
FIND RELIEF FROM VARICOSE VEINS VenaSeal Closure System UNDERSTAND Varicose veins may be a sign of something more severe venous reflux disease Your doctor can help you understand if you have this condition.
More informationUNDERSTANDING VEIN DISEASE. UC EN - For use in the U.S. only
UNDERSTANDING VEIN DISEASE UC201706537 EN - For use in the U.S. only Do you need to sit down during your work day because your legs ache and/or swell? Do you miss out on doing the activities you love because
More informationPerforators: When to Treat and How Best to Do It? Eric Hager, MD September 10, 2015
Perforators: When to Treat and How Best to Do It? Eric Hager, MD September 10, 2015 Anatomy of Perforating veins Cadaveric studies 1 have shown >60 vein perforating veins from superficial to deep Normal
More informationVein & Body Specialists at The Bellevue Hospital Spider Vein and Varicose Vein Treatments
1 Vein & Body Specialists at The Bellevue Hospital Spider Vein and Varicose Vein Treatments What are spider veins? Spider veins are dilated, small blood vessels that have a red or bluish color. They appear
More informationVaricose Veins are a Symptom of Vein Disease. Now you can treat the source of your varicose veins with non-surgical endovenous laser treatment.
Varicose Veins are a Symptom of Vein Disease. Now you can treat the source of your varicose veins with non-surgical endovenous laser treatment. Approximately 1 in 5 adult Americans suffer from superficial
More informationVenous Insufficiency Ulcers. Patient Assessment: Superficial varicosities. Evidence of healed ulcers. Dermatitis. Normal ABI.
Venous Insufficiency Ulcers Patient Assessment: Superficial varicosities Evidence of healed ulcers Dermatitis Normal ABI Edema Eczematous skin changes 1. Scaling 2. Pruritus 3. Erythema 4. Vesicles Lipodermatosclerosis
More informationThe effective solution to varicose veins
The effective solution to varicose veins For Effective Varicose Vein Treatments Performed over 1000 Ultrasound Guided Sclerotherapy Treatments All Treatments Performed by a Cosmetic Physician Partially
More informationLASERS: CAN THEY TREAT SPIDER VEINS? Steven E. Zimmet, MD
LASERS: CAN THEY TREAT SPIDER VEINS? Steven E. Zimmet, MD No conflicts of interest DISCLOSURES YES! WHY USE LASERS FOR LEG VEINS? Patient s Perception Less Painful Newer technology Must be better Needle
More informationPROF S.R.SUBRAMMANIYAN INSTITUTE OF VASCULAR SURGERY MADRAS MEDICAL COLLEGE
PROF S.R.SUBRAMMANIYAN INSTITUTE OF VASCULAR SURGERY MADRAS MEDICAL COLLEGE VARICOSE VEINS OF SUPERFICIAL VENOUS SYSTEM OF LOWER LIMBS A SYMPTOM NOT A DISEASE INITIAL,MILD CASES and severe cases with contraindication
More informationFind From Varicose Veins. VenaSeal
Find Relief From Varicose Veins VenaSeal Closure System Understand Varicose veins may be a sign of something more severe venous reflux disease. Your doctor can help you understand if you have this condition.
More informationClinical/Duplex Evaluation of Varicose Veins: Who to Treat?
Clinical/Duplex Evaluation of Varicose Veins: Who to Treat? Sanjoy Kundu MD, FASA, FCIRSE, FSIR The Vein Institute of Toronto Scarborough Vascular Group Scarborough Vascular Ultrasound Scarborough Vascular
More informationMedStar Health, Inc. POLICY AND PROCEDURE MANUAL Policy Number: MP.066.MH Last Review Date: 11/08/2018 Effective Date: 01/01/2019
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL This policy applies to the following lines of business: MedStar Employee (Select) MedStar CareFirst PPO MedStar Health considers the treatment of Varicose
More informationVaricose Vein Cyanoacrylate Glue treatment
The South West s premier independent healthcare and cosmetic clinic Varicose Vein Cyanoacrylate Glue treatment Varicose veins are a sign of underlying venous insufficiency and affect 20 30% of adults.
More informationPATIENT STUDY INFORMATION LEAFLET
PATIENT STUDY INFORMATION LEAFLET BOOKLET 1 You are invited to take part in this research study. Before you decide, it is important for you to understand why the research is being done and what it will
More informationDr Paul Thibault. Phlebologist & Assistant Editor Phlebology (International Journal) Australasian College of Phlebology
Dr Paul Thibault Phlebologist & Assistant Editor Phlebology (International Journal) Australasian College of Phlebology Prescribing Effective Compression and PTS Dr Paul Thibault Phlebologist, Newcastle,
More informationFIND RELIEF FROM VARICOSE VEINS. VenaSeal Sapheon Closure System
FIND RELIEF FROM VARICOSE VEINS VenaSeal Sapheon Closure System UNDERSTAND Varicose veins may be a sign of something more severe. Your doctor can help you understand if you have this condition. may cause
More informationA treatment option for varicose veins. enefit" Targeted Endovenous Therapy. Formerly known as the VNUS Closure procedure E 3 COVIDIEN
A treatment option for varicose veins. enefit" Targeted Endovenous Therapy Formerly known as the VNUS Closure procedure E 3 COVIDIEN THE VENOUS SYSTEM ANATOMY The venous system is made up of a network
More informationPeter B. Morgan, M.D.
Peter B. Morgan, M.D. Specialized Vein Care Spider Veins Spider veins are small blue/black veins seen on your legs. They are called spider veins because they appear like spiders. These veins are always
More informationPATIENT EDUCATION HANDBOOK
PATIENT EDUCATION HANDBOOK Welcome from Our Founder and CEO 1 What is Venous Insufficiency 2 What Factors Can Cause Varicose Veins? 2 Our Procedures 3 Pre- and Post-Operative Instructions 4 Sclerotherapy
More informationOHTAC Recommendation. Endovascular Laser Treatment for Varicose Veins. Presented to the Ontario Health Technology Advisory Committee in November 2009
OHTAC Recommendation Endovascular Laser Treatment for Varicose Veins Presented to the Ontario Health Technology Advisory Committee in November 2009 April 2010 Issue Background The Ontario Health Technology
More informationPROCEDURES FOR SPIDER AND VARICOSE VEINS. Reducing Symptoms and Improving Appearance
PROCEDURES FOR SPIDER AND VARICOSE VEINS Reducing Symptoms and Improving Appearance Understanding Leg Vein Problems Do your legs feel tired and achy at the end of the day? Are you unhappy about visible
More informationTreatment of Varicose Veins
Treatment of Varicose Veins Policy Number: Original Effective Date: MM.06.016 04/15/2005 Line(s) of Business: Current Effective Date: PPO; HMO; QUEST Integration 09/28/2018 Section: Surgery Place(s) of
More informationVaricose Veins Operation. Patient Information Leaflet
Varicose Veins Operation Patient Information Leaflet April 2017 1 WHAT IS VARICOSE VEIN SURGERY (HIGH LIGATION AND MULTIPLE AVULSIONS) The operation varies from case to case, depending on where the leaky
More informationThermal Ablation 101: Basics of RF and Laser
1:48-2:00 Now 11 min flying Thermal ablation indications, contraindications, results, complications (30 min) Thermal Ablation 101: Basics of RF and Laser Nick Morrison, MD, FACPh, FACS, RPhS President,
More informationTreatment of telangiectasias by. foam sclerotherapy? under. ultrasound guidance. How to ensure the success of. 10 rules to respect
How to ensure the success of foam sclerotherapy? under 10 rules to respect Treatment of telangiectasias by ultrasound guidance Claudine Claudine Hamel-Desnos MD Hôpital Privé Caen- Saint France Martin
More informationNew Technologies in Superficial Vein Treatment
New Technologies in Superficial Vein Treatment Ariel D. Soffer, MD, FACC Associate Clinical Professor Florida International University Medical School Ariel Soffer, MD, FACC Bio Fellow of the American College
More informationPATIENT STUDY INFORMATION LEAFLET
PATIENT STUDY INFORMATION LEAFLET BOOKLET 1 You are invited to take part in this research study. Before you decide, it is important for you to understand why the research is being done and what it will
More informationPHLEBOLOGY. Venous Insufficiency. Presentation Use Information
Disclosure of Conflict of Interest THE BASICS OF VENOUS INSUFFICIENCY: What You Should Know. An Introductory Lecture Donald Ives, MD, RVT, RPVI Board Certified Family Physician Diplomate of the American
More informationCurrent Management of Varicose Veins
Current Management of Varicose Veins Michael J. Heidenreich, MD St. Joseph Mercy Hospital Ann Arbor, MI March 23, 2013 Nothing to disclose History Prevalence Anatomy Risk factors Clinical manifestations
More informationVaricose Vein Surgery
What are varicose veins? Varicose veins are enlarged and twisted veins in your leg. Varicose veins are common, affecting up to 3 in 10 people. Varicose veins tend to run in families and are made worse
More informationInformation about minimally-invasive vein therapy
Information about minimallyinvasive vein therapy Table of Contents 2 Healthy Legs... 3 Modern Examination... 6 Compression Therapy... 7 Sclerotherapy... 8 MiniPhlebectomy... 10 Laser Therapy (Endolaser)...
More informationPeripheral Vascular Examination. Dr. Gary Mumaugh Western Physical Assessment
Peripheral Vascular Examination Dr. Gary Mumaugh Western Physical Assessment Competencies 1. Inspection of upper extremity for: size symmetry swelling venous pattern color Texture nail beds Competencies
More informationManagement of Superficial Reflux: Which option, when? Kathleen Gibson, MD Lake Washington Vascular Surgeons Bellevue, WA
Management of Superficial Reflux: Which option, when? Kathleen Gibson, MD Lake Washington Vascular Surgeons Bellevue, WA DISCLOSURES Kathleen Gibson, MD Consultant/Advisory Board: BTG, Medtronic Speakers
More informationCoolTouchCTEV. Endovenous 1320nm Laser Treatment for Varicose Veins
CoolTouchCTEV Endovenous 1320nm Laser Treatment for Varicose Veins 99% EFFICACY Science. Results. Trust. 99% efficacy rate short procedure time fewer risks and complications than vein stripping ideal outpatient
More informationPACKAGE LEAFLET: INFORMATION FOR THE USER. Fibrovein 3%, 1%, 0.5% and 0.2% Solution for Injection Sodium tetradecyl sulphate
PACKAGE LEAFLET: INFORMATION FOR THE USER Fibrovein 3%, 1%, 0.5% and 0.2% Solution for Injection Sodium tetradecyl sulphate Read all of this leaflet carefully before you start using this medicine. Keep
More informationConflict of Interest. None
Conflict of Interest None American Venous Forum Guidelines on Superficial Venous Disease TOP 10 GUIDELINES 10. We recommend using the CEAP classification to describe chronic venous disorders. (GRADE 1B)
More informationChronic Venous Insufficiency
Chronic Venous Insufficiency None Disclosures Lesley Enfinger, MSN,NP-C Chronic Venous Insufficiency Over 24 Million Americans affected by Chronic Venous Insufficiency (CVI) 10 x More Americans suffer
More informationALTERNATIVE TREATMENTS
INSTRUCTIONS This is an informed-consent document that has been prepared to help inform you of otoplasty surgery, its risks, as well as alternative treatments. It is important that you read this information
More informationEndovenous Laser Therapy INFORMATION & TREATMENT INSTRUCTIONS
1324 Princess Street Kingston, ON K7M 3E2 Website: www.ucosmetic.com Email: nuyu@ucosmetic.com Phone: (613) 536-LASR (5277) Fax: (613) 536-5108 Dr. Kim Meathrel, MD, FRCSC, Plastic Surgeon, Associate Professor
More informationINFORMED CONSENT OTOPLASTY SURGERY
2005 American Society of Plastic Surgeons. Purchasers of the Patient Consultation Resource Book are given a limited license to modify documents contained herein and reproduce the modified version for use
More informationEndo-Thermal Heat Induced Thrombosis (E-HIT)
Endo-Thermal Heat Induced Thrombosis (E-HIT) Michael Ombrellino MD FACS The Cardiovascular Care Group Clinical Associate Professor of Surgery Rutgers School of Medicine Objectives: What is E-HIT? How do
More informationRECOGNITION AND ENDOVASCULAR TREATMENT OF CHRONIC VENOUS INSUFFICIENCY
RECOGNITION AND ENDOVASCULAR TREATMENT OF CHRONIC VENOUS INSUFFICIENCY Paul Kramer, MD, FACC, FSCAI Liberty Cardiovascular Specialists Liberty Regional Heart and Vascular Center DISCLOSURES NONE Venous
More informationSincerely, Michael R. Probstfeld, M.D., FACS Southern Arizona Laser & Vein Institute A MESSAGE ABOUT OUR PATIENT HISTORY FORM
A MESSAGE ABOUT OUR PATIENT HISTORY FORM. Dear Patients, Thank you in advance for taking the time to accurately complete our SALVI patient questionnaire. This valuable tool helps us to help you. Due to
More informationCriteria For Medicare Members. Kaiser Foundation Health Plan of Washington
Clinical Review Criteria Treatment of Varicose Veins Radiofrequency Catheter Closure Sclerotherapy Surgical Stripping Trivex System for Outpatient Varicose Vein Surgery VenaSeal Closure System VNUS Closure
More informationWound Care Medicine. Gaston Dana D.O.
Wound Care Medicine Gaston Dana D.O. Financial Disclosures Siemens Healthcare Toshiba Medical Systems Inc. Philips Healthcare Carestream Health GE Healthcare Shimadzu Corporation Global Health Corporation
More informationThe Vascular Disease Almost No One Teaches But Should!!! Chronic Venous Insufficiency
The Vascular Disease Almost No One Teaches But Should!!! Chronic Venous Insufficiency Thomas E. Eidson, DO Certified Venous Disease Specialist Board Certified Family Medicine Disclosure of Conflict of
More informationSclerosing Agents: Tips & Tricks Session: Liquid Embolics
Sclerosing Agents: Tips & Tricks Session: Liquid Embolics Jeffrey S. Pollak, M.D. Robert I. White, Jr., M.D. Professor of Interventional Radiology Yale University School of Medicine Department of Radiology
More informationOriginal Article Intervention
Original Article Intervention http://dx.doi.org/10.3348/kjr.2014.15.4.481 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2014;15(4):481-487 Fluoroscopy-Guided Endovenous Sclerotherapy Using a Microcatheter
More informationUNDERSTANDING VEIN PROBLEMS
UNDERSTANDING VEIN PROBLEMS Varicose Veins, Chronic Venous Insufficiency, and DVT Do You Have a Vein Problem? Have you noticed pain or swelling in your legs? Do your symptoms worsen when you re sitting
More informationEndovenous Radiofrequency and Laser Ablation
Endovenous Radiofrequency and Laser Ablation [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr go to Comunicados a Proveedores, and click Cartas Circulares.]
More informationInstructions for Use
Page 1 Instructions for Use ASSEMBLY The SyrEase takes literally just seconds to assemble. Once assembled the thumb rest comfortably on top of the thumb grip of the device which slides along the barrel
More informationThermal Techniques: Outcomes and Complications
Thermal Techniques: Outcomes and Complications Meet The Experts: Thermal and Non-Thermal Ablation Techniques Joseph D. Raffetto MD VA Boston HCS, West Roxbury, MA, Harvard Medical School, Boston, MA; Brigham
More informationLong-term vein diameter reduction by perivenous hyaluronan instead of tumescence for endovenous procedures
Long-term vein diameter reduction by perivenous hyaluronan instead of tumescence for endovenous procedures Johann Chris Ragg, MD founder & head of angioclinic Vein Centers Europe founder & head of SWISS
More informationV11 Endovenous Ablation
For the personal patients of Bruce Braithwaite V11 Endovenous Ablation What are varicose veins? Varicose veins are enlarged and twisted veins in the leg. They are common, affecting up to 3 in 10 people.
More informationBUTTONHOLE CANNULATION
BUTTONHOLE CANNULATION What is a Buttonhole? Technique in which an AV fistula is cannulated in the exact same spot, at the same angle and at the same depth of penetration every time. Benefits Reduction
More informationAging hands are characterized by prominent
Foam Sclerotherapy for Reticular Veins of the Dorsal Hands: A Retrospective Review Anne Marie Tremaine, MD,* Daniel P. Friedmann, MD, and Mitchel P. Goldman, MD BACKGROUND Despite being the gold standard
More informationTREATMENT OPTIONS FOR CHRONIC VENOUS INSUFFICIENCY
TREATMENT OPTIONS FOR CHRONIC VENOUS INSUFFICIENCY TL LUK Consultant Vascular Surgeon Sarawak General Hospital HKL Vascular Conference 19/06/2013 PREVALENCE OF LOWER LIMB VENOUS DISEASE Affects half of
More informationManagement of Post-Thrombotic Syndrome
Management of Post-Thrombotic Syndrome Thanainit Chotanaphuti Phramongkutklao College of Medicine Bangkok, Thailand President of CAOS Asia President of Thai Hip & Knee Society President of ASEAN Arthroplasty
More informationTessari L. Nouvelle technique d'obtention de la sclero-mousse. Phlebologie 2000;53:129.
Appendix 1 to Microsclerotherapy Standard AUSTRALASIAN COLLEGE OF PHLEBOLOGY CLINICAL PROCEDURES CP - Microsclerotherapy - Clinical procedure 1 PURPOSE This procedure summarises the actions required to
More informationPatient assessment and strategy making for endovenous treatment
Patient assessment and strategy making for endovenous treatment Raghu Kolluri, MD Director Vascular Medicine OhioHealth Riverside Methodist Hospital Columbus, OH Disclosures Current Medtronic Consultant/
More informationEndovenous ablation treatment of varicose veins under local anaesthetic
Patient information: Endovenous varicose vein treatment (LA) Endovenous ablation treatment of varicose veins under local anaesthetic Introduction The vascular consultant (doctor specialising in veins and
More informationTechniques and Specific Treatment Modalities for the Active Non-Healing Wound. Luke Maj, MD, MHA
Techniques and Specific Treatment Modalities for the Active Non-Healing Wound Luke Maj, MD, MHA Assistant Professor of Radiology University of Miami, Miller School of Medicine Director of The Vein Center
More informationAVOIDING COMPLICATIONS IN LIQUID SCLEROTHERAPY. Steven E. Zimmet, MD RPVI RVT FACPh
AVOIDING COMPLICATIONS IN LIQUID SCLEROTHERAPY Steven E. Zimmet, MD RPVI RVT FACPh Disclosures No conflicts of interest Overview Hyperpigmentation Matting Ulceration Thrombosis Anaphylaxis Neurological
More informationGSV treatment with Radio Frequency EVRF device and CR45i catheter CLINICAL STUDY
GSV treatment with Radio Frequency EVRF device and CR45i catheter CLINICAL STUDY _ BY Dr. Thomas Niesen St Louis Surgical Consultant 226 South Wood Mills Road, Suite 49 West Chesterfield, Mo 63017 Tel:
More informationRecurrent Varicose Veins
PHLEBOLOGY Recurrent Varicose Veins Part 2: Injection of Incompetent Perforating Veins Using Ultrasound Guidance PAUL KENNETH THIBAULT, MBBS WARREN ANTHONY LEWIS, DMU Treatment options following duplex
More information