Kevin P. Kern, DO

Products And Services

• Ambulatory Phlebectomy

  An ambulatory phlebectomy, also called a microphlebectomy or stab phlebectomy, is an outpatient procedure performed to remove spider and varicose veins through small, slit-like incisions in the skin. When varicose veins near the surface of the skin are too large to treat with sclerotherapy and too small to treat with laser ablation, microphlebectomy is the preferred treatment. Since veins are extremely collapsible, even the largest affected veins can often be removed through tiny incisions using the ambulatory phlebectomy procedure. This minimally invasive treatment does not require sutures or general anesthesia and can easily be performed in the doctor's office with minimal downtime. Ambulatory phlebectomy involves less pain and fewer risks than traditional surgical treatment. Reasons for Ambulatory Phlebectomy Some patients seek treatment for their varicose veins for cosmetic purposes, while others are concerned about the potential risks of their damaged veins. Untreated veins can lead to pain, inflammation and discoloration. They can also affect the flow of oxygen-depleted blood between the lower legs and the heart. Ambulatory phlebectomy treats symptomatic and asymptomatic veins and can relieve both cosmetic and medical concerns in one simple procedure. After damaged veins have been removed, other healthy veins in the leg will absorb the excess blood and reinstate a normal blood flow. Functioning will not be affected by removing the damaged veins, as there are many surrounding veins to take over. Ambulatory Phlebectomy Procedure The ambulatory phlebectomy procedure is performed on an outpatient basis. This procedure takes about 45 to 60 minutes to perform. The doctor will first identify the veins to be treated to ensure precise removal and to help preserve the health of surrounding veins and tissue. Before beginning the surgery, the doctor will inject a local anesthetic into the skin. Patients generally do not experience any discomfort during the procedure. Tiny incisions will be made in the targeted areas, and a surgical hook will be inserted to extract the damaged veins section by section. The incisions are very small and frequently no stitches are required. Veins are very collapsible such that even large veins may be removed through the tiny incisions used in this technique. The patient will be required to wear compression bandages for a week after surgery to help minimize swelling and discomfort. Risks of Ambulatory Phlebectomy Patients who are allergic to local anesthesia or those who cannot wear compression stockings should not undergo the ambulatory phlebectomy procedure. Any active infections or rashes should be thoroughly treated before this procedure as well.. Although an ambulatory phlebectomy is considered quite safe, there are certain risks associated with any surgical procedure. In a few cases, there may be residual inflammation and irritation resulting from an incomplete removal of damaged veins. Other risks may include: A nerve injury to the skin Adverse reaction to anesthetic or sedative Severe bleeding or swelling Numbness or pain in the feet Post-surgical infection Thrombophlebitis Recovery from Ambulatory Phlebectomy Some bruising, discomfort and swelling are to be expected after an ambulatory phlebectomy. Swelling and pain can be minimized with compression garments and over-the-counter pain medications, and are usually only temporary. Patients will be able to walk and carry on with normal activities immediately after the ambulatory phlebectomy procedure, though they will have to wear compression stockings for the first week. They can usually return to work the next day, although exercise and heavy lifting should be avoided for about two weeks. The incisions from this procedure do not require sutures and are able to heal on their own, and are often barely visible after six to twelve months. Some patients may experience mild skin pigmentation at the site of the varicose vein, but this usually goes away on its own after a short time. Most people see effective results from an ambulatory phlebectomy since damaged veins have been completed removed. Ambulatory phlebectomy offers permanent effective results for most patients, although it is possible for new varicose veins to develop, particularly in patients with a family history of varicose veins. The risk of recurrence can be minimized if the patient maintains a proper weight and an active lifestyle.

  Link: Ambulatory Phlebectomy

• Aortogram

  An aortogram is a specialized X-ray examination of the blood vessels within the abdomen. The aortogram is performed to detect narrowed or closed areas that may indicate an abdominal aneurysm. Your doctor may recommend this procedure if you are experiencing pain in your legs. The aortogram may also be performed to evaluate an aneurysm prior to surgery. During the aortogram, a catheter is inserted into the groin, under local anesthesia, and guided to an artery in the abdomen. A contrast dye is injected into the area and images are taken as the dye moves throughout the body. After the aortogram, the patient will need to rest for a few hours and should drink plenty of liquids before returning to their regular activities. Exercise and other types of strenuous activity should be avoided for a week after this procedure.

  Link: Aortogram

• Arterial Doppler

  An arterial doppler is a non-invasive diagnostic test performed to evaluate blood flow in different areas of the arms and legs. Doppler technology uses sound waves to identify differences in blood pressure in various areas and to help diagnose narrowing or blockage of major arteries. Symptoms which may alert patients and doctors to possible trouble may include: Leg or arm pain Numbness and tingling Fatigue During the arterial Doppler procedure, blood pressure is taken with a cuff at various points along the arms and legs. While these readings are being taken, a handheld device called a transducer is moved across each area. By measuring changes in pitch through ultrasound, the transducer detects variations in blood flow before and after the cuff is inflated, producing images of them on a screen for the doctor to examine. An arterial Doppler assists in the diagnosis of various medical conditions which may include: Blocked arteries Peripheral artery disease Blood clots Venous insufficiency Heart valve defects and congenital heart disease Aneurysms Arterial stenosis The arterial Doppler test is performed in the ultrasound or radiology department or in a vascular lab and takes under an hour to be administered. Patients may experience mild cramping as the cuff temporarily cuts off circulation in a given area, but may return to their normal routine immediately after the test is completed.

  Link: Arterial Doppler

• Carotid Angioplasty with Stent Placement

  Carotid angioplasty and stent placement is a minimally invasive procedure performed to open blocked arteries and improve blood flow. During the procedure, the surgeon will permanently place a stent to keep the artery open, preventing or treating a stroke. The carotid arteries are located on each side of the neck and are the arteries responsible for blood flow to the brain. Before undergoing carotid angioplasty and stent placement, the doctor will perform a physical examination and review the patient's medical history. Diagnostic tests such as an ultrasound, magnetic resonance angiography (MRA), or carotid angiography (CTA), may be done at this time to ensure that this procedure can treat the patient's condition. The doctor will provide the patient with specific pre-surgical instructions with regard to eating, drinking, and medication use before the procedure. The Carotid Angioplasty and Stent Placement Procedure Carotid angioplasty and stent placement is performed under sedation. Before the procedure begins, X-ray images of the carotid artery are taken, antiseptic solution and local anesthetic are applied to the groin or arm area, and electrode pads are placed onto the patient's chest to monitor their heart rate during the procedure. Once the sedative has taken effect, the doctor will create a small puncture in an artery, either the femoral artery, in the groin area or the brachial artery, in the arm area. A small tube, known as a sheath, is inserted into the artery, and with the assistance of X-ray guidance, a catheter is threaded through the sheath. Contrast material is injected into the carotid artery through the catheter. This provides a better image of the carotid artery and the location of either the blockage or narrowing. A filter, shaped like an umbrella, is then sent through the catheter to catch any fragments that may fall from the blocked part of the artery reducing the risk of a blood clot or stroke. A balloon is inserted into the constricted area and inflated to expand the vessel. A stent is inserted into the newly expanded vessel to support the walls of the artery. The filter, sheath and catheter are removed, and pressure is applied at the catheter's insertion point to stop bleeding. Recovery After the Carotid Angioplasty and Stent Placement Procedure After carotid angioplasty and stent placement, the patient will need to lie still for several hours to prevent bleeding. An ultrasound of the carotid artery may be necessary after the procedure. An overnight stay at the hospital is usually required, and lifting objects over 10 pounds and other strenuous activities must be avoided for at least one day following the procedure. For the next few days, the patient may experience bruising, swelling, or tenderness at the site of the catheterization, although this can usually be managed with over-the-counter painkillers. As with most procedures, there are certain risks associated with carotid angioplasty and stenting. These risks may include bleeding, stroke, development of a blood clot, or a re-narrowing of the carotid artery. Patients can minimize the occurrence of complications by closely following their aftercare instructions.

  Link: Carotid Angioplasty with Stent Placement

• Carotid Artery Ultrasound

  A carotid artery ultrasound is a diagnostic procedure that uses high-frequency sound waves to generate images of the neck's internal carotid arteries, which supply oxygen-rich blood to the brain. A carotid artery ultrasound is used to evaluate a patient's risk of stroke or other cardiovascular complications by checking for artery-narrowing plaque buildup. In general, candidates for carotid artery ultrasound are those who are at high risk for, or beginning to display the symptoms of, carotid artery disease. Candidates include those who have recently had a stroke or carotid artery surgery; have an abnormal sound in, or damage to the walls of, a carotid artery; or are suspected of having blood clots in a carotid artery. High-risk candidates for carotid artery disease include those who have been diagnosed with diabetes or high cholesterol, or have a family history of heart disease. During the ultrasound procedure, the patient lies faceup on a table, and a doctor applies a cool gel to both sides of the neck, at each artery's location. A transducer is moved over the arteries to give off sound waves; the sound waves' echoes bounce off the artery walls and blood cells, and are converted into images by a computer. The images, usually in black and white, are then displayed on a computer screen. If a Doppler ultrasound is included in the test, the flow of blood through the arteries can be detected; blood flow is usually shown in color. A carotid artery ultrasound is performed in a doctor's office, and usually takes less than 30 minutes. There are no risks associated with a carotid artery ultrasound, and patients can return to their regular activities immediately afterward. Results are discussed with the patient shortly after the ultrasound is completed.

  Link: Carotid Artery Ultrasound

• Carotid Endarterectomy

  Carotid endarterectomy is a surgical procedure performed to remove plaque buildup inside the carotid artery so that normal blood flow may be restored. This procedure is usually recommended for patients who have suffered from a transient ischemic attack (TIA) or stroke, and whose carotid arteries are at least 70 percent blocked. After the patient has received general anesthesia, a carotid endarterectomy will begin with an incision made in the neck to expose the narrowed carotid artery. A shunt is put in place to direct blood flow away from the area being operated on. The surgeon opens the artery and removes the plaque, usually in one piece. A vein from the leg may be grafted onto the carotid artery in order to widen it. The shunt is removed and all incisions are closed. The carotid endarterectomy procedure usually takes two hours. A hospital stay is usually required after a carotid endarterectomy. Day-to-day activities can be continued about a week after surgery, as long as they don't involve strenuous physical labor. Neck aches may last for about 2 weeks after surgery so it is important that the patient not to turn their head too fast during the recovery period. As with any surgical procedure, there are risks associated with the carotid endarterectomy procedure. Some of these risks include a reaction to anesthesia, the development of blood clots, a heart attack, stroke, redevelopment of plaque buildup, infection and death.

  Link: Carotid Endarterectomy

• Coronary Artery Bypass Surgery

  Coronary artery disease is a condition in which the arteries that supply blood and oxygen to the heart become narrowed and hardened. Typically, this condition is caused by the build up of plaque and fat on artery walls, which narrows the vessels that connect to the heart. This narrowing of the arteries restricts blood from reaching the heart, and proper circulation of blood and oxygen is not provided to the heart and its surrounding tissue. Blood clots can also form and completely block the artery. Coronary artery disease develops gradually and can eventually lead to a heart attack or heart failure. Coronary artery disease is often initially treated with medication, and in some cases, angioplasty and stenting are performed. For many types of blockages however, coronary bypass surgery is the best option for treatment. The coronary artery bypass procedure creates new pathways for oxygen-rich blood to flow into the heart and bypass the blocked arteries. During the coronary artery bypass procedure, one or more blocked coronary arteries are bypassed using a blood vessel grafted from another part of the body, restoring normal blood flow to the heart. The blood vessel grafts come from the patient's own arteries and veins in either the chest, leg, or arm. The Coronary Artery Bypass Procedure General anesthesia is administered to the patient during coronary bypass surgery. The surgery can be performed "on-pump" with the use of a heart-lung bypass machine or as an "off-pump" procedure also known as "beating heart" surgery. The type of method that is used depends upon the patient's age, health and an evaluation of the patient's heart and arteries. During surgery the sternum is divided and the heart is temporally stopped. Based on the prior evaluation, the patient's vital functions may become fully supported by a cardiopulmonary bypass pump which takes over the function of the heart and lungs, blood circulation and oxygen content of the body. Healthy blood vessels are taken, often from inside the chest wall or from the lower leg, and attached to the the ends above and below the blocked artery so that blood flow is diverted, or bypassed around the narrowed portion of the clogged artery. The coronary artery bypass procedure generally takes about 3-5 hours to perform, depending on the number of arteries that are being bypassed. On average, two to four coronary arteries are repaired during this procedure. A minimally invasive form of coronary artery bypass surgery may also be performed. In this procedure, the coronary bypass is performed through a smaller incision in the chest, often with the assistance of robotics and video imaging that help the surgeon operate in a small area. Recovery from Coronary Artery Bypass Surgery After coronary artery bypass surgery, most patients spend 1 to 2 days in the cardiac intensive care unit for monitoring. Monitoring includes continuous heart function, blood pressure and oxygen monitoring and frequent vital sign checks. Overall, the patient is hospitalized for about 1 week. Medications such as statins and cholesterol-lowering medicine are often prescribed after surgery. Most patients will take part in a cardiac rehabilitation program as a part of their recovery. Most people can return to work within 4 to 6 weeks and full recovery usually takes about 10 weeks. Risks of Coronary Artery Bypass Surgery As with any invasive procedure there are risks associated with coronary artery bypass surgery. Risks include: Bleeding Infection Heart arrhythmias Heart attack Stroke The risk of developing these complications depends on the overall health of the patent prior to surgery. Any concerns should be discussed with a doctor prior to undergoing surgery. Although bypass surgery improves blood supply to the heart, it does not cure underlying coronary artery disease. Medication and healthy lifestyle changes are strongly recommended to reduce the risk of recurring heart disease, and the need for additional heart surgery in the future.

  Link: Coronary Artery Bypass Surgery

• Coronary Computed Tomography Angiogram

  A coronary computed tomography angiogram, also known as a coronary CTA, is a minimally invasive diagnostic procedure used to detect a buildup of fat or calcium within the coronary arteries, the arteries that supply blood to the heart. Through images produced with contrast dye, the coronary CTA examines the blood vessels of the body to help identify any abnormalities. Reasons for a Coronary CTA Patients at risk for coronary artery disease should have a coronary CTA to check for early signs of the disease, and help prevent permanent damage. This test is often effective in identifying problems in patients with no symptoms, and is also helpful in diagnosing coronary disease in patients with abnormal symptoms. Additional reasons that a physician may order a coronary CTA include: To investigate a possible aneurysm To examine blood vessels for atherosclerosis To find abnormal blood vessel formations in the brain To identify damaged blood vessels To identify blood clots that may have traveled Evaluate tumors fed by blood vessels A coronary CTA may help to prevent a heart attack or stroke or prepare a patient for a kidney transplant. The Coronary CTA Procedure During the coronary CTA procedure, an iodine contrast dye is injected into a vein in order to produce clear, accurate images. Through the same IV, medication is administered to slow or stabilize the heart rate for better imaging results before X-rays are passed through the body. The results are then used to create 3-D images that can help the doctor identify any signs of coronary artery disease. Benefits of a Coronary CTA A coronary CTA is less invasive than most other commonly used heart tests, since it does not require the insertion of a catheter or transport tube into the coronary arteries. The CTA is often useful in screening for coronary artery disease because it is cost- and time-effective and has an extremely low risk of side effects. No radiation is used during this procedure. Risks of a Coronary CTA While a coronary CTA is generally a safe procedure, and the amount of radiation used during the CTA is very small, for certain patients its risks may outweigh its benefits. Since contrast dye may damage the kidneys, patients with diabetes or severe kidney disease may not be able to have this test administered. Patients who are pregnant or nursing need to notify their physicians before undergoing this procedure. Risks for other individuals, though rare, are related to the contrast material which may cause allergic reactions or, in the event of leakage at the IV site, tissue damage.

  Link: Coronary Computed Tomography Angiogram

• Endovenous Radiofrequency Ablation

  Endovenous radiofrequency ablation is a minimally invasive alternative to vein stripping for the treatment of varicose veins. Varicose veins are veins in which the valves are damaged to the point that there is a backflow of blood, called venous reflux. Venous reflux interferes with efficient circulation and causes blood to pool in the affected veins and cause distention. Endovenous radiofrequency ablation of varicose veins offers patients effective results with less pain, less bleeding and a shorter recovery period than traditional procedures. This procedure is performed for medical and cosmetic purposes under local or general anesthesia. Endovenous radiofrequency ablation is usually performed in an hour or less. Benefits of a Endovenous Radiofrequency Ablation Radiofrequency treatment offers benefits over vein stripping and other treatment methods. These benefits may include the following: Speed of the procedure Short recovery time Little discomfort Little or no scarring or bruising Less swelling The Endovenous Radiofrequency Ablation Procedure During the radiofrequency ablation, a small incision is made through which a catheter is inserted into the targeted vein. Once the catheter is precisely placed, radiofrequency energy is directed into the wall of the vein, causing the vein to collapse and seal so that blood can no longer travel through it. Once the damaged vein has been sealed, blood is naturally rerouted through other, healthier veins in the body. The Risks of a Endovenous Radiofrequency Ablation While radiofrequency ablation is considered a safe procedure, there are certain risks associated with any type of surgical treatment. Some of the risks of this procedure may include: Numbness Infection Failure of the procedure Deep vein thrombosis, an extremely rare complication The Recovery from a Endovenous Radiofrequency Ablation After the radiofrequency procedure, patients may experience mild bruising and swelling in the treated area, but are usually able to return to your regular activities shortly after treatment. In most cases, patients will be required to wear compression garments for several weeks to promote healing and relieve any symptoms of swelling and bruising. The results of the endovenous radiofrequency ablation treatment are usually visible within a week or two after treatment, at which point symptoms tend to subside as well. Ninety-seven percent of patients were well-satisfied with the results of their endovenous radiofrequency ablation one year after treatment.

  Link: Endovenous Radiofrequency Ablation

• Endovenous Laser Therapy

  Endovenous Laser Therapy, known as EVLT, is a minimally invasive procedure used to treat unsightly varicose veins. It is an alternative to the painful, lengthy ligation and stripping procedure. EVLT is fast, safe, and effective and provides cosmetic benefits which improve the patient's quality of life. This simple procedure is performed in the doctor's office and takes less than an hour. Ligation and stripping was once the primary treatment for varicose veins since it was the only treatment available. While effective, ligation and stripping is an invasive surgical procedure that was performed under general anesthesia and required up to two weeks of recovery time. Many patients experienced pain during and after this procedure since several incisions were involved in the process. EVLT offers patients a highly effective, but much less invasive, alternative. Benefits of Endovenous Laser Therapy EVLT is a relatively uncomplicated procedure. Some of the benefits of this therapy include that EVLT: Takes less than an hour to perform Is an outpatient procedure Offers immediate relief from symptoms Does not necessitate a long recovery Does not require general anesthesia Results in no scarring Has a success rate of 98 percent Endovenous Laser Therapy Procedure During the EVLT procedure, the doctor first marks the damaged vein and prepares the area with an antiseptic. Once a local anesthetic has been applied to the area to minimize any pain, a laser probe is inserted through a needle inserted into the vein. The physician maneuvers the probe precisely, using ultrasound imaging to identify problems in particular veins and positioning the laser accordingly. The laser energy is then targeted along the length of the damaged vein, causing its walls to collapse so that blood can no longer flow through. Blood from this vein will be diverted to functional veins. As these healthy veins take over, circulation frequently improves and symptoms are relieved. Once the procedure of endovenous laser therapy is completed, the probe is removed from the vein and a dressing and compression bandages are applied to the area. The entire EVLT procedure takes less than an hour to perform and is a viable option for almost all patients.. Risks of Endovenous Laser Therapy Although EVLT is considered safe, there are certain risks associated with any surgical procedure. Some of these risks may include: Numbness A drawing sensation Phlebitis Deep vein thrombosis Infection Failure of the procedure Recovery from Endovenous Laser Therapy After the EVLT procedure, most patients experience mild bruising and tightness in the legs, although these side effects usually subside within a few days. Patients can return home immediately and many are able to resume work and other normal activities the very same day. Exercise and heavy lifting should be avoided for some time. Results from the EVLT procedure are visible immediately. Once the procedure is completed and recovery has taken place, most patients can enjoy pain-free, more attractive legs. As many as 98 percent of patients who have EVLT are satisfied with the results. Because the level of satisfaction is much higher for EVLT is than for comparative procedures, EVLT is quickly becoming the new standard for treating varicose veins.

  Link: Endovenous Laser Therapy

• Foam Sclerotherapy

  Foam sclerotherapy is a medical procedure used to treat varicose veins. Varicose veins result from weakened valves which keep the veins from functioning properly and allow blood to pool in the legs. Varicose veins may be not only unattractive but medically problematic. During foam sclerotherapy, a sclerosant solution is injected into the affected veins, causing their eventual collapse. These damaged veins will be absorbed by the body and blood flow will naturally be rerouted through other, healthy veins. The Foam Sclerotherapy Procedure To ensure precision, foam sclerotherapy is performed with the aid of ultrasound imaging. The affected veins are injected with a foamed sclerosant solution, which causes the veins to eventually collapse and be absorbed into the bloodstream. This safe procedure can be performed outpatient, in the doctor's office and takes less than an hour to complete. Anesthesia is not needed for foam sclerotherapy. After the skin is cleaned with an antiseptic solution, the sclerosant is injected into the affected veins with a very fine needle. The number of injections per session varies based on the number and length of the damaged veins. After the sclerotherapy procedure, cotton balls and compression tape are applied to the injection site. Patients usually report only a mild burning sensation during the treatment. Recovery from Foam Sclerotherapy After foam sclerotherapy, most patients can immediately return work and regular activities the same day. Exercise and other strenuous activities, however, should be avoided for 7 to 10 days. Compression bandages may need to be worn for a week to 10 days after the procedure, and some patients may experience mild bruising and discoloration following sclerotherapy; but these side effects usually subside within a few days. The results of foam sclerotherapy are usually fully visible after 3 to 6 weeks. To preserve the results of sclerotherapy, patients should maintain an active, healthy lifestyle after the procedure. Risks of Foam Sclerotherapy While sclerotherapy is a safe procedure, there are certain risks associated with any procedure of this type. Rare complications may include: nerve damage, phlebitis, deep vein thrombosis, infection or failure of the procedure. Most patients are very satisfied with the results of this treatment.

  Link: Foam Sclerotherapy

• Sclerotherapy

  Sclerotherapy is a minimally invasive medical procedure used to treat varicose and spider veins, most commonly found on the legs, by collapsing them through the use of a solvent. Sclerotherapy has been used on patients since the 1930s with great success, producing increasingly effective medical, as well as cosmetic, results. Reasons for Sclerotherapy Some of the reasons a patient may desire, or a physician may recommend, sclerotherapy may include one or more of the following symptoms: Pain, aching or burning sensations in the legs or feet Swelling or redness at the site Cramping of the legs, especially at night Scaly, dry or discolored skin at the site Discomfort after sitting or standing for long periods Individuals troubled by varicose veins may choose, in consultation with their physician, to undergo sclerotherapy either because they find them unattractive or because the diseased veins are causing unpleasant and/or dangerous symptoms. The Sclerotherapy Procedure During sclerotherapy, a solution of saline and a sclerosant is injected into the damaged veins. This will cause irritation in the affected veins and produce their eventual collapse. During this procedure, the surgeon is guided through the use of ultrasound to ensure precision. When the weakened veins collapse, they will be reabsorbed into the body and other healthier veins will take their place in the circulatory system. Sclerotherapy has proven to be a safe procedure and is performed outpatient in the doctor's office. Typically, sclerotherapy is performed in less than an hour, although a varying number of injections may be required, depending on the number of veins involved. Patients do not require an anesthetic and usually report little or no discomfort during the procedure, only a mild burning sensation. In some instances, several sclerotherapy treatments may be necessary. Risks of Sclerotherapy Although sclerotherapy is a safe procedure that has been successfully performed for many years, there are certain risks associated with any medical procedure. Certain minimal, temporary side effects are to be expected, including bruising and discoloration. More serious complications are rare, but may include: Inflammation Swelling, warmth and discomfort around the injection site may indicate the presence of an infection for which the doctor may prescribe antibiotics. Blood Clot A lump of clotted blood may form in a treated vein and require drainage. Rarely, a deeper blood clot may develop, known as a deep vein thrombosis. Since there is danger that such a clot will break off and travel to the chest, resulting in a pulmonary embolism, such a clot requires urgent medical attention. Sudden shortness of breath, chest pain, dizziness or the coughing up of foamy blood are signs of pulmonary embolism and must be addressed immediately. Air Bubbles Tiny air bubbles may rise in the bloodstream. These may not result in any symptoms, but if the patient experiences visual disturbances, headache, coughing or nausea, the physician should be contacted. Nerve Damage Numbness or odd sensations in the affected limb following sclerotherapy should always be investigated. While rare, it's possible for a patient to have a severe allergic reaction to the sclerosant used in the treatment. Recovery from Sclerotherapy Patients are able to return home shortly after sclerotherapy. Most can return to work and resume normal activities the next day, although exercise and strenuous activities are to be avoided a week or two. Compression bandages usually need to be worn for a week or so after the procedure. While it may take up to a month for the patient to see full results, some improvement is usually visible immediately. In order to promote vascular health and to preserve the positive effects of the sclerotherapy, it is recommended that patients maintain a healthy weight and make exercise part of their daily routine.

  Link: Sclerotherapy

• Venous Ultrasound

  Venous ultrasound is used to diagnose vascular conditions in the legs. This procedure can effectively detect blood clots in the legs that may cause dangerous conditions such as deep vein thrombosis or pulmonary embolism. While many diseased leg veins are visible on the skin in the form of varicose or spider veins, some patients may experience significant venous reflux, or back flow, that can only be detected through ultrasound imaging. A venous ultrasound shows a thorough, detailed image of the veins, along with the direction of blood flow, to help accurately diagnose vascular conditions. Reasons for Using Venous Ultrasound This procedure can identify narrowed or blocked arteries or veins or faulty valves. Venous ultrasound is an essential part of successful vein treatment. Most often it is performed on patients with leg swelling, varicose or spider veins, or patients with symptoms of peripheral artery disease or venous insufficiency. Symptoms of these conditions may include: Pain, cramping, numbness, itching Pain made worse by standing Pain improved by elevating the leg Discoloration or hardening of the skin on the leg Ulceration of the leg The ultrasound procedure is an alternative to venography or arteriography. In addition to assisting in the diagnosis of ongoing vascular conditions, venous ultrasound may also be utilized to diagnose the extent of vascular injuries and to evaluate vascular repair. The process may also be used to pinpoint a location for needle or catheter placement Venous Ultrasound Procedure The venous ultrasound procedure is a straightforward, noninvasive one, usually performed in a vascular laboratory or in the ultrasound or radiology department of a hospital. During the procedure, a clear gel is applied to the targeted area of the legs and a transducer is moved across the site. The transducer sends out high frequency sound waves which produce an image on a screen of the blood vessels in question, showing any blockage, clot, narrowing, occlusion or spasm of the blood vessel being viewed. Conditions which may be diagnosed through the use of venous ultrasound include: Arteriosclerosis of the extremities Deep vein thrombosis Thrombophlebitis Peripheral artery disease Vascular tumors of the arms or legs. During a venous ultrasound, blood pressure cuffs may be applied at various points on the body, including the ankle, calf, thigh, and at various spots along the arm. This allows the doctor to compare blood pressure at various sites. In some cases, a Doppler ultrasound is used. This type of ultrasound measures the speed and direction of blood flow. The patient experiences no pain during a venous ultrasound so there is no anesthesia or recovery required. Another advantage of this diagnostic test is that the image on the computer screen appears immediately so it can be reviewed by the doctor and patient at the time of the procedure. There are no risks associated with the ultrasound procedure. There is no exposure to radiation. Depending on the results of the venous ultrasound, the doctor will be able to personalize an appropriate treatment.

  Link: Venous Ultrasound