Thursday, April 16, 2020

5 Qualities of the Best Vein Clinic

Are you looking for a vein clinic near me
Trying to decide which vein center has the best reputation can seem like a daunting task. A simple google search for “best vein clinic near me” will populate at least 12 different clinics all offering very similar vein treatments. Fortunately, there are some qualities that are invariable among the best vein treatment centers. We are here to help you start that process!

5 Qualities of the Best Vein Clinic Highly-Qualified Vein Doctors

The quality of vein doctors is understandably the most important consideration when looking for the best vein clinic. The vein clinic should have physicians with a strong pedigree and vascular-specific board-certification. Patients should be aware that the term "board certification" alone is not enough. Instead, an educated patient will seek out vein specialists that have board certifications that explicitly state vascular training---this ensures those physicians have received formal residency training to practice interventional procedures and venous medicine. The only specialties that offer formal procedural training during residency for venous medicine are surgery (vascular, general or cardiothoracic) and interventional fellowships (radiology and cardiology). So, be specific to ask what board-certification was achieved!

Minimally Invasive Vein Treatment Procedures

Did you know that vascular surgery is no longer necessary in the treatment for varicose veins. However, that does not mean that a vascular surgeon or cardiovascular specialist shouldn’t be the one treating you. The treatment of vein disease remains specialized and deciding who and what treatment is best for you still requires a vascular expert. Nonetheless, today’s best vein clinics do manage most vein disease with minimally invasive non-surgical techniques. That means a scalpel should not be the primary tool for vein treatment.

If you’re suffering from venous insufficiency, the vein clinic should offer treatments like radiofrequency ablation, endovenous laser ablation, venaseal, and varithena. During these procedures, the vein doctor uses no more than a tiny needle or IV line to treat the vein completely. Once the unhealthy veins are treated and closed, the circulation is immediately improved and blood reroutes to healthier veins to relieve symptoms of congested blood flow.
In addition to venous insufficiency treatments, the vein clinic should also feel comfortable with cosmetic treatments for spider and varicose veins. All too often, patients seeking cosmetic treatments are guided to higher end treatments like ablation without offering solutions for visible spider veins. Instead, patients may be directed to medical spas or dermatologists to complete treatments at an additional cost. Sclerotherapy and ambulatory phlebectomy are the preferred treatments for surface veins and should be discussed as part of a complete management strategy.

The Staff
It is not enough for a vein clinic to just have the best doctors and latest technologies. Pay attention to the individuals assisting your vein doctor and completing your vein evaluation. Vein clinics run as a team, and one of the most overlooked members is the ultrasonographer. These individuals have completed formal training in the diagnosis and treatment of vein disease using ultrasound technique. They are the backbone of a good clinic and will help provide the necessary information to your vein doctor to make treatment plans. If the data provided to your doctor is not coming from a reliable source, then you should consider an alternative clinic. Vein clinics that prioritize the hiring of certified and experienced sonographers have made a commitment to safety and the quality of their clinic. At the best Mt Laurel Vein centers, the team of ultrasound technicians and physicians are all certified by ARDMS.

Strong Online Presence and Track Record
Finally, the vein clinic’s online presence can tell you a lot about their quality of care. In the modern age, it’s absolute for vein clinics to maintain an educational website and have a strong online presence. If the vein clinic’s website looks dated, it’s likely that their investment into the rest of their practice is also questionable.

Personalized Approach
Finally, it’s also important that the vein treatment center takes a personalized approach to treatment. Vein treatment is elective and should always feel that way. The purpose of your vein consultation should be to present your concerns and goals for treatment. Beyond being friendly, the vein specialist should provide a comprehensive evaluation that takes into full account your medical and family history, along with your symptoms. This will allow your vein doctor to make appropriate recommendations and what results can be expected. We will say it again--vein treatment is not a one size fits all approach. Finally, there should always be enough time for questions and answers with the vein doctor without feeling rushed to make treatment decisions.

Schedule a Consultation with the Best Clinic for Vein Treatment
Based on all the above-mentioned factors, you should be able to locate “the best vein clinic near me”. If you suspect you suffer from vein disease, you should make certain you consult with a reputable vein treatment center. Vein disease is a medical condition and if untreated can lead to the formation of varicose veins, bleeding, skin changes, leg ulcers, and even deep vein thrombosis. The best vein clinics will carefully examine all of your symptoms in order to individualize a treatment plan just for you.

We hope this brief summary provides you information to find the best vein clinic near your location!

Wednesday, April 8, 2020

Virtual Vein Doctor

What is a Virtual Doctor Visit?

A virtual doctor visit has become part of the norm with the recent outbreak of COVID-19.  Due to the interests of public health and safety, in person evaluations are reserved for the evaluation and treatment of emergent conditions including COVID-19.   

With most of us spending our time at home away from work and school, individuals are eager to take advantage of some of the extra time and schedule non-urgent visits with their doctors.  Virtual consultations provide that avenue and allow for full interaction with your doctor from the comfort of your home. The consultations can be performed with any desktop computer, laptop or smartphone with capability for audio/visual communication.  Today, we are seeing that the vein doctor near me has embraced this new technology and we are hopeful that some of this change is here to stay for good.  Virtual consults allow anyone to vet the doctor of their choice before making an in-person visit. You can be as picky as you want before settling on the best vein doctor for you.

Benefits of a Virtual Doctor Visit
  • Currently due to the COVID-19 outbreak in the United States that has severely affected both NJ and NY, virtual consults eliminate the need for leaving your home
  • Full and thorough evaluations at your convenience with the doctor of your choosing
  • Take advantage of free time to settle the concerns you had about your vein disease, including varicose and spider veins
  • No wait times!  Your scheduled appointment is made in advance and dedicated to your schedule
  • Video communication allows the vein specialist to get a complete appreciation of your varicose and spider veins
  • If your vein disease is considered significant and needs further evaluation, additional tests can be scheduled without making unnecessary trips
  • Covered by medical insurances 

Frequently Asked Questions
Does the evaluation have to be using tele-medicine?
Some Vein centers have take additional steps to accommodate patients without tele-medicine access to still interact with the doctor using web-based forms.  Although it does not allow real-time interaction, interested individuals can submit their concerns and questions to the vein doctor. These questions are answered promptly and allow for patients to schedule an in-person or tele consultation at their convenience.

Are Virtual Consults covered by Insurance?
Online consultations are treated in the same was as in-person evaluations. The coverage is equivalent and in some cases, cost sharing can be waived (depending on your plan).  

How are Virtual Consults Performed?
The virtual consultation will feel similar to any other visit.  You will be called by the front desk before your scheduled time to verify demographics and provide any assistance you may require to log-in.  In the exam room portal, you will meet with the vein doctor to discuss your symptoms, medical history , and other important details relevant to your care.  Next, a physical examination will focus on visual identification of any spider veins, varicose veins, ulcerations, swelling, skin discoloration, phlebitis, and corona phlebatica. Your vein doctor may also ask you to perform some self-maneuvers to assist with the evaluation.  Based on this information, the vein doctor will determine the need for any additional testing or treatment recommendations. These will be scheduled once again with the office staff and will be an in-person evaluation. At that time, you will again have an opportunity to meet the doctor.

Article source: https://centralnjveinclinic.weebly.com/blog/virtual-vein-doctor

Tuesday, March 31, 2020

Pathophysiology of Vein Disease

Vein Disease characterization has been advanced by modern ultrasound techniques, including doppler and color flow. A proper vein specialists in NJ must be knowledgeable in both the performance and reading of venous ultrasound.

The venous system is a holding tank for circulating blood, generally holding up to 70% of the volume at any given time. The circulating blood within veins is transported back to the heart to start a new cycle of oxygenation and recirculation to body tissue and organs.

A dysfunctional venous system is the result of damage to vein walls and valves that result in varicose vein problems. This has been demonstrated under microscopic slide examination.
With vein injury, the size of the veins will increase and lead to valve dysfunction and venous reflux. The effect of this long term is an increase in venous pressure and venous hypertension which is more commonly seen in superficial veins that don’t have the same support as deep veins. The clinical manifestations of venous hypertension include leg cramps, leg swelling, ulceration, and skin discoloration. It's also a common reason why varicose veins itch.

The cosmetic result of venous hypertension is spider and varicose veins, whereas venous insufficiency is more serious and can cause leg swelling and leg ulcerations. Clinical ultrasound has served to facilitate mapping of the underlying venous disorders to guide therapies including endovenous ablation, sclerotherapy and most recently VenaSeal. See before and after pictures of spider veins with treatment.

Friday, March 6, 2020

Six Stages of Varicose Vein Disease

Vein disease is quite prevalent in the US with nearly 1 out of every 4 Americans affected. The disease is more common in females and is most often seen with an inheritance pattern. The most visible symptoms of vein disease are spider and varicose veins, however most suffering from vein disease are unaware of the other potential symptoms and signs related to venous insufficiency. Having awareness of typical signs and symptoms of vein disease is important to avoid progression of vein disease and seeking early diagnosis at a reputable vein clinic.

What Should Tip You Off to Vein Disease?
If you have vein disease it is common to experience some of these symptoms
  • Leg pain
  • Leg heaviness
  • Leg cramps
  • Spider veins
  • Varicose veins
  • Skin discoloration
  • Restless leg syndrome
  • Leg Ulcers
Vein disease is characterized by stages known as the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) with the greatest attention given to the clinical manifestations. This article will help educate the reader on the different stages of vein disease and proper identification to avoid later complications.
CEAP Class 1:
Spider VeinsThe presence of Spider or Reticular veins are typically the first signs of venous disease.
What Do Spider Veins Look Like?
Telangectasias (or spider veins) are tiny capillaries right on the surface of the skin. They usually form distinct networks or “webs” and can be either bluish/purple or red in color.
What Do Reticular Veins Look Like?
Reticular veins appear as green or blue linear veins on the surface of the skin. They are smaller than varicose veins and do not bulge from the skin. Many times, reticular veins will be noted to underlie a bed of spider veins and as such are referred to as feeder veins. Getting rid of such spider veins will also depend on treating these feeder (or reticular veins).
What Causes Spider and Reticular Veins?
Venous insufficiency and genetics are the most common culprits. Venous insufficiency refers to dilated and incompetent veins underneath the surface of the skin related to either truncal veins or perforator veins. Venous insufficiency is what is responsible for the symptoms of vein disease. The most common reasons for venous insufficiency are:
  • Family history
  • Prolonged standing or sitting at work or home
  • Pregnancy (multiple increases risks)
  • Hormone changes or imbalances
  • Obesity
  • Smoking
Stage 1 disease is often cosmetic in nature and treated with sclerotherapy or vein removal near me. However, a thorough examination by a qualified vein doctor will consider additional symptoms to explore venous insufficiency before cosmetic treatments.
CEAP Class 2:
Varicose VeinsVaricose veins are larger and more dilated veins that appear underneath the surface of the skin as twisted, enlarged veins. It is during Stage Two when individuals become bothered by the appearance and symptoms of vein disease.
  • Family history
  • Prolonged standing or sitting
  • Pregnancy or menopause
  • Hormone changes or imbalances
  • Obesity
More often than not, spider and reticular veins are treated as a cosmetic issue
Stage Two: Varicose VeinsVaricose veins are larger and more dilated veins (> 3mm) that appear on and above the surface of the skin as twisted, dilated veins. This tends to be the most bothersome sign of vein disease because of the disturbing appearance.
Varicose veins don’t always cause pain or obvious symptoms, but educated patients will realize some of the symptoms may have been considered something else. Proper attention requires a level of understanding that leads to early diagnosis and treatment of venous insufficiency.
Symptoms of Varicose Veins
  • Bulging, dark purple or blue veins
  • Burning or itchy legs
  • Pain and heaviness in the legs
  • Restless legs at night
  • Charlie horses
  • Pain after prolonged periods of standing
  • Skin discoloration on legs near the varicose vein
  • Superficial phlebitis (inflammation of the vein causing pain)
  • Varicose vein bleeding
Causes of Varicose Veins
The problem involves veins in the lower extremities that suffer from high pressure from within. Naturally, blood pools in these veins due to gravity, resulting in high pressure within the veins. Over time, these vein walls can become damaged from the constant pressure and suffer from venous insufficiency. This is when symptoms such as leg cramps, heaviness, and swelling should no longer be ignored.
Risk FactorsThe risk factors for spider veins and varicose veins are the same. Again, the most important determinant is likely to be a family history of vein disease.
CEAP Class 3:
SwellingStage three marks more advanced vein disease and is a strong reason to seek an evaluation. Leg Swelling may be present without obvious signs of spider or varicose veins. The cause of swelling is due to venous insufficiency and indicates increased venous pressures. However, swelling is also a sign of other serious conditions such as hypertension, heart failure, renal or liver disease, malnutrition, lymphatic disease and blood clots. These conditions should be properly considered along with venous insufficiency.
Symptoms Accompanying Leg Swelling/Inflammation:
  • Leg heaviness
  • Skin indented from external pressure (socks, fingertips, etc.)
  • Itchy, dry skin
  • Muscle spasms
  • Leg ulcers due to significant leg swelling
These symptoms should prompt immediate attention from a health professional or your vein doctor.
CEAP Class 4:
Skin Discoloration/PigmentationAt this stage of vein disease, the appearance of your skin as skin becomes thinner and even some discoloration becomes visible. This is due to the chronic venous hypertension and pooling of blood in the lower extremities that leads to inflammatory changes on the skin.
Symptoms of Skin Discoloration
  • Brown or purplish discoloration of the skin (concentrated around the shins and ankles)
  • Skin thickening and/or hardening around varicose veins
  • Corona Phlebatica
  • Leg ulcers
For advanced stages of vein disease (CEAP class 4-6), it’s very important to receive attention from a qualified vein specialist and sometimes even a wound clinic to help manage the disease. Treatment for venous insufficiency becomes paramount if detected by ultrasound.
CEAP Class 5 and 6: Healed and Active UlcersLeg ulcerations result from the chronic, untreated inflammatory condition that results from advanced venous insufficiency. This stage requires coordinated care from a vein specialist and wound clinic, especially with active ulcerations. Most recently, a randomized study reported in the NEJM demonstrated the superiority of early endovenous ablation treatment for the healing of active ulcers in comparison to conservative treatment. This has encouraged the early identification of superficial venous reflux disease in the treatment of leg ulcers.
Putting It All Together:
Spider veins and Varicose Veins represent a continuum of vein disease that culminates in more serious medical concerns with advanced, untreated venous insufficiency.
Awareness of all types of symptoms related to vein disease, especially in the presence of spider or varicose veins should prompt early attention by a vein specialist
The importance of identifying vein disease was strongly supported by recent randomized data demonstrating more rapid healing of leg ulcers with modern vein treatments in comparison to compression stockings and delayed ablation.
Modern vein treatments seek to cure underlying venous reflux using catheter based techniques that are minimally-invasive and improved efficacy. Early treatment for symptomatic vein disease at CEAP class 2 or greater is appropriate when conservative therapies have not alleviated symptoms.

Article Source: 

Saturday, February 29, 2020

Do Varicose Veins Itch?

If you are seeking care from a vein doctor for itchy varicose veins, you can be certain that you are not the only one. While many think that varicose veins are purely cosmetic, vein disease can have many manifestations. Varicose veins are just one symptom of a more serious underlying issue--chronic venous insufficiency. The itchy feeling patients experience from varicose veins is a more advanced symptom and suggest inflammation at the level of the skin. These symptoms don’t happen overnight and thus it's important to seek early vein evaluations.
And while the cosmetic issues can be covered and even suppressed with compression socks and long pants, the feelings associated with venous insufficiency can become unbearable for many individuals. These symptoms include itchy veins, swollen legs, leg fatigue, leg cramps, leg pain and skin discoloration.
 
Why Do Varicose Veins Itch?
Varicose veins develop because of chronic venous insufficiency. In this condition, truncal or superficial veins become dysfunctional. This can result from many different causes including employment or lifestyles that lead to prolonged periods of standing or sitting, obesity, smoking, pregnancy are common associated issues. Genetics plays the largest role and many patients will identify parents or siblings with varicose veins.
In chronic venous insufficiency, the circulation becomes impaired in the superficial veins. The veins are dilated and the valves become dysfunctional unable to keep blood from refluxing (or falling back down) with gravity. Unlike deep veins, there is no significant muscle or tissue to prevent the veins from dilating further and worsening the problem.
This poor circulation effort leads to blood to pool in the legs and cause symptoms of venous insufficiency. Spider and varicose veins result from the over-distended veins that cause new , diseased veins to form.
 
As the situation worsens with time, the continued pooling of blood becomes chronically irritated and inflammatory to the walls of the veins and the surrounding tissue. This includes the skin which can become eczematous, itchy and discolored. Untreated this condition can lead to venous stasis changes or permanently discolored and eczematous. In the most serious cases, skin ulcers (CEAP 5 and 6), infections and bleeding can occur.
 
How to treat itchy varicose veins?
The eczema that results from venous insufficiency needs early treatment. Moisturizers and steroids can help resolve very irritated skin, but the key is to treat the underlying issue to prevent chronic insults on the skin.

Fortunately, these treatments are readily available and can be done with relative ease in the hands of the best vein doctors. Modern treatments are minimally-invasive and catheter based technologies that eliminate the need for surgical removal of veins. Combination treatments with foam sclerotherapy or ambulatory phlebectomy can eliminate some of the most unsightly varicose veins once the underlying issue is resolved. If you are seeking expert venous care, make sure you see a board-certified vein specialist as soon as possible.

Tuesday, February 18, 2020

Treatment of Hand Veins

Increasingly, veins in the hands are becoming popular among aesthetic treatments and within the Tri-State area, many patients are wondering what is the best treatment to get rid of veins on the hands.

However, in light of the complex arterial and venous anatomy of the hand, it’s imperative that such treatment be only considered in the hands of a specialized vein doctor Cherry Hill NJ.
Is there a preferred way to treat hand veins?
Treatment options for undesired veins in the hands include sclerotherapy and ambulatory phlebectomy.

With sclerotherapy, the target vein is directly injected with either polidocanol or STS. Foam sclerotherapy may be preferred for best vein treatment effect. Compression therapy post treatment is advised, however is done with elastic bandages for 48 hours without interruption. The importance of an experienced physician cannot be over emphasized as the medication being improperly injected or over done can have serious consequences. The qualified vein doctor will be aware of the volume and concentration to have a desired effect and will prescribe appropriate post care to avoid complications such as DVT and phlebitis.

Ambulatory phlebectomy is also performed for hand vein treatments. Under sterile technique and local anesthesia, a small Mueller hook is used to exteriorize the target vein similar to varicose veins in the legs. Post procedure, compression is similar to sclerotherapy. With either sclerotherapy or ambulatory phlebectomy, the main side effect is bruising and swelling. In some cases, filler will be needed post phlebectomy to even out the surface of the hands.

If you are considering removal of hand veins, most varicose vein doctors near me will consider sclerotherapy as the primary choice of treatment. However, in some cases AP may be more appropriate. The judgement of a qualified vein doctor who specializes in both techniques and hand veins is important to be certain you will have a safe and desirable outcome.

Monday, February 3, 2020

Ultrasound to Detect Vein Disease

Duplex ultrasound (DUS) has become the gold standard for evaluating signs and symptoms of venous insufficiency. The test can be performed in 20-60 minutes directly in the office to provide information on vein disease and vein reflux. The examination is best performed by a registered ultrasound technician for accuracy and quality. A proper vein specialists in NJ should also be knowledgeable in both the performance and reading of venous ultrasound.
It is recommended that symptomatic patients with leg pain or leg swelling who have physical findings consistent with CEAP stages 2-6 undergo clinical evaluation with duplex ultrasound for detection of chronic venous insufficiency.
For superficial venous evaluation, the primary veins that are evaluated on ultrasound include the GSV, SSV and their primary tributaries. The ultrasound should be performed with pulse wave doppler using a linear 7.5-10MHz transducer. The end goal is to identify incompetent truncal veins and perforator veins. The deep system should also be carefully evaluated to exclude any disease. The vein specialists NJ utilize modern guidelines from the American College of Phlebology to ensure proper performance and documentation of exams.
The exam is generally performed in the standing position, though reverse trendelenburge can be also considered in patients vulnerable to vagal episodes or dizziness with prolonged standing. During examination, the veins are evaluated for size, wall characteristics, debris, and vein reflux. The venous reflux portion is measured with pulse wave doppler and is assisted by augmentation maneuvers. Venous blood flow is characterized by movement of blood towards the heart and any incompetent valves can be detected by abnormal reflux or regurgitation exceeding 500 milliseconds on doppler ultrasound. Vein doctors in New Jersey are expected to review these results prior to vein treatment recommendations. Vein Clinics in New Jersey will recommend treatment based on symptoms and ultrasound findings that are consistent. Insurance coverage for vein treatment in New Jersey is carrier specific and should be discussed in detail with the vein doctor New Jersey before proceeding.
Duplex ultrasound is also just as important in the follow up after vein treatment for varicose veins. Radiofrequency ablation and sclerotherapy are effective methods to cure spider veins and varicose veins, however duplex ultrasound permits post treatment monitoring for effectiveness and safe outcomes, such as excluding endovenous heat induced thrombosis (EHIT) from ablation. There are 4 stages of EHIT that are closely examined in the post procedure follow up ultrasound.
As such, DUS is required for diagnosis, pre-treatment planning, and follow up after vein treatment with radiofrequency ablation, laser ablation , sclerotherapy and venaseal.