10 Most Frequently Asked Questions

South Georgia Vein Center

1.   Q:  Do I need a referral to be seen at South Georgia Vein Center?

      A:  This may depend upon your particular insurance coverage.  Most primary care physicians recognize the advantage of seeing a vein specialist and will gladly provide the referral.  However, we can see almost all patients without a referral.  If one is needed, you may call our office and we can help to facilitate that for you ahead of time or even work with you after the initial office visit to obtain the referral if necessary.

2.   Q:  Will insurance pay for my vein procedure?

      A:  Almost all insurance plans will cover the cost of varicose vein procedures including Endovenous Laser Treatment (EVLT) as well as Microphlebectomy.  In some circumstances there may even be coverage for Sclerotherapy or treatment of spider veins.  We would be better able to determine this at the time of the initial consultation as the coverage can be circumstantial and dependent upon the symptoms, physical examination or ultrasound findings.  Our staff will take care of any pre-authorization or paper work needed prior to scheduling a procedure to help ensure appropriate reimbursement.

3.   Q:  What is Sclerotherapy?

      A:  Sclerotherapy is used to treat both spider veins in addition to certain types or variations of varicose veins.  Sclerotherapy involves using very small caliber needles to inject special medication into the diseased vein which causes it to close off.  Here at our center, we use an FDA-approved drug called Sotradecol (sodium tetradecyl sulfate).  Sotradecol is not painful like the more obsolete saline injections which are used by many other clinics.  Also, Sotradecol has a much better safety profile and is dramatically more effective compared to saline or other agents available.  It should be noted that use of a foamed version of the medication during Sclerotherapy gives the most dramatic improvement in getting good long term results with spider veins as well as certain types of varicose veins.

4.   Q:  What is EVLT?

      A:  EVLT stands for Endovenous Laser Treatment.  This is an exciting new technique that has emerged as the standard of care for the treatment of most cases of varicose veins and has replaced the now traditional vein stripping or high ligation type techniques worldwide.  The Endovenous Laser Ablation version of endothermal ablation techniques has some advantages over the use of Radio Frequency Closure including the financial and clinical elements.  EVLT involves threading a laser fiber into the diseased vein and firing it along the length of the vein after it has been numbed in the office setting.  This effectively seals or closes the vein, preventing blood flow and the increased pressure associated with varicose veins.  These procedures are all done here at our office facility under local anesthesia (numbing medication).  This treatment has dramatically better safety and long term results compared to other types of varicose vein treatments especially compared to traditional vein stripping surgery.  The patient can be back to most activities and work within one to three days and the treatment is virtually scarless as well.

5.   Q:  Are the treatment results permanent?

      A:  Endovenous Laser Treatment for varicose veins has excellent long term results which are in fact dramatic in representing multifold improvements over the now more obsolete traditional vein stripping type procedures especially.  In addition, especially with the development of foamed sclerotherapy techniques, we are seeing much better long term results from spider vein therapy.  Most people who have spider veins have diseased veins which "feed" the spider veins.  By treating these in addition to the spider veins themselves we now can get good symptom relief as well as preventing the recurrence of at least the majority of treated veins in addition to even preventing the development of future varicose veins and spider veins.  These new techniques represent substantial advances in long term results and do offer permanent results and improvements for many patients.  By treating the underlying diseased veins, the chances of recurrence are much lower for both varicose and spider veins.

6.   Q:  Several years ago, I underwent a vein stripping.  My varicose veins are back.  Should I even bother to do anything about them?

      A:  Previous traditional vein stripping techniques and their related procedures often did not correctly identify or treat the underlying problem or the underlying diseased veins with valve leakages and may not have been previously eliminated.  The first step is to undergo our initial consultation which will include an ultrasound to determine why your varicose veins have recurred.  At this point the treatment plan eliminating the source, which may include Endovenous Laser Treatment or ultrasound guided foamed sclerotherapy injections, may be recommended.  These procedures are done in the office setting and have a dramatically lower risk of recurrence of varicose veins and the majority of patients have excellent lifetime results.

7.   Q:  If I have my varicose veins removed, will my spider veins disappear?

      A:  The first step is to eliminate all higher or larger sources of venous high blood pressure such as large varicose veins.  Once that has been accomplished you may find that the small skin vessels or spider veins will fade or shrink.  If they persist, they can be treated thereafter with sclerotherapy or surface laser at a later date.

8.   Q:  Is there any chance that I will need my veins for future heart bypass surgery?

      A:  Diseased veins are not suitable for coronary artery bypass procedures.  However, this is an example of why a duplex ultrasound by the treating physician is so important.  During the initial consultation the exact source of your problem will be defined and the normal veins will be left untreated.  In fact, treating the diseased vein may help to protect the remaining normal veins of the leg as this reduces stress to them.

9.   Q:  Is DVT (deep vein thrombosis or blood clot) a concern after Endovenous Laser Treatment or other therapies in your clinic?

      A:  DVT is a rare complication in a vein center where patients are up and walking almost immediately.  In fact, many of our procedures actually reduce your future risk of developing DVT or other blood clot risk complications substantially.  Hospital-based procedures associated with general anesthesia carry the highest risk of DVT.

10. Q:  I have a lot of varicose veins and I am worried about a blood clot.  Should I seek treatment?

      A:  It is important to differentiate between superficial thrombophlebitis which is a clot in the varicose vein or associate vein and the type of phlebitis that occurs in the deep veins of the leg (DVT).  The former is self-limiting while the latter is potentially health or life threatening and requires urgent medical treatment and even possible hospitalization.  Having varicose veins is a risk factor for both of the above and some consider it to be in and of itself a compelling reason to consider treatment in addition to concerns over pain, swelling, disability, or even cosmetic appearance.

Answers provided by: Gregory D. Martin, M.D., F.A.C.S.