Sclerotherapy Manual for Doctors

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2 The Complete Sclerotherapy Cycle

3 1. The First Medical Visit 1-42 The Eleven Steps of the First Visit Physical Examination Functional Tests 3D Venous Map Venous Classification Multifactor Scale Differential Diagnosis Managing Therapy Options Charts and Summary of the First Medical Visit The 3D Venous Map Objective and Benefits of the Venous Map Venous Map Procedure for Filling out the Venous Map International Venous Classification (CEAP) Varicose Veins Scale and Categories Charts and Summary of the Steps for 3D Venous Map

4 3. Vascular Tests Types of Vascular Tests Arterial Doppler Steps for Arterial Doppler Arterial Imaging The How and Why of Venous Examinations Techniques Used in the Examination Deep Vein System Superficial Vein System Charts and Summary of Vascular Tests The Second Medical Visit Evaluating Test Results Sclerotherapy Indications & Contraindications Results Derived from the Second Visit Educating the Patient Informed Consent Charts and Summary of the Second Visit

5 5. How to Make Sclerotherapy Estimates Importance of Estimates Problems with the Estimates Methodology for Making Estimates The Six Steps Patient Index-Mathematical Formula Therapist Index-Mathematical Formula Estimate of Required Therapies Mathematical Formula Charts and Summary of How to Make Sclerotherapy Estimates Treatment Plan Elements to be Considered in the Treatment Plan The 8 Steps for Developing the Treatment Plan Goals to be Reached with Sclerotherapy Pre-Sclerotherapy Recommendations Summary Chart of the Treatment Plan

6 7. Sclerotherapy Techniques and Procedures Physiopathology of Sclerotherapy/Endothelium Classification and Use of Sclerosants Concentration of the Medication The Dichotomous Technique Sclerotherapy Method or Schools The 13 Steps of Sclerotherapy The 22 Most Important Injection Techniques The Second Sclerotherapy How to Control the Sclerotherapy Charts and Summary of Sclerotherapy Procedure Treating Sclerotherapy Complications List of Sclerotherapy Complications Treatment for Each Complication (Urticaria, Superficial Thrombus, Skin Necrosis, Blisters, Hyperpigmentation, etc.) Serious Systemic Reactions Eight Factors that Increase Risk of DVT/PE Charts and Summary for Treating Sclerotherapy Complications

7 9. Sclerotherapy Progress Control Objectives of Controlling the Progress of Treatment Type and Frequency of the Treatment Control Therapist Report on the Progress of Sclerotherapy Physician Report on the Treatment Plan Chart and Summary of Sclerotherapy Progress Control Medical Reference for Varicose Disease Anatomy and Physiology of the Vein System Deep Vein System Superficial Vein System Perforators Anatomical References The Endothelium and its Functions Physiology of the Vein System Pathophysiology of Varicose Veins Manifestations, Conditions and Complications Photographic References/ Before & After Side Effects Graphic Summary of the Full Sclerotherapy Cycle

8 Introduction Crown Medical manuals is the result of more than 29 years of experience of numerous Doctors, Nurses, and Administrators whom have been exclusively devoted to the art of Sclerotherapy. Over the years, Crown medical has successfully established facilities throughout the United States all which have been solely dedicated to the treatment of varicose veins utilizing Sclerotherapy. This fact has provided us with an exceptional and distinctive experience like no other, having treated thousands of patients of all nationalities and ethnicities. Thus, acquiring the day to day experience on how to accurately treat varicose veins of all calibers and implementing the adequate solution to complications which may arise. Since this manual belongs to a complete business system aimed to facilitate you in implementing Sclerotherapy, it is truly an inimitable manual for those who wish to become or are involved in this area. The Sclerotherapy manual covers all elements and phases of Sclerotherapy, from both a medical and managerial point of view, as illustrated through The Complete Sclerotherapy Cycle diagram and constituted in the The Table of Contents of the medical manual. Each chapter has been written in a user-friendly fashion. Every concept has been graphically depicted. The objective is to provide you and your staff with the visual aids and resources necessary to acquire and implement concepts found within this manual. All tasks within this manual are presented in the logical order in which they occur when treating a patient s varicose disease. In other words, from what to do the very moment the patient enters the lobby of your medical center up to when the patient concludes his/her treatment. To get an overview of how this book is structured observe The Sclerotherapy Cycle diagram found on the following page.

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