Before
After
p A 55-year-old man before and after bilateral endovenous laser ablation, ambulatory phlebectomy and sclerotherapy.
below the surface of the skin. This allows the medication to be administered to precise locations safely and accurately. The solution used for injections is FDA approved and safe, says Dr. McHutchison, and the procedure is relatively painless, so no anesthesia or sedation is needed. The Carolina Vein Center website (www. carolineveincenter.com) offers videos that show the remarkably quick improvement that results with sclerotherapy. Endovenous laser ablation and ambulatory phlebectomy are surgical techniques that replace vein stripping and are often performed in combination for the best results. They require only 2-3 millimeter incisions and local anesthetic or mild sedation. The micro-incisions are closed with sterile tape, not sutures, and leave barely a mark when healed. Ambulatory plebectomy is used to remove large bulging varicose veins at the skin’s
surface. Endovenous laser ablation uses a thin laser fiber (or catheter) inserted into the saphenous veins. The catheter delivers laser energy (heat) to the wall of large varicose veins, causing them to heat, collapse and seal shut. Contrary to the old-fashioned regimen of bed rest after vein treatment, patients today are instructed to walk as much as possible after treatment. This helps re-route blood to the deeper, healthier veins. A compression bandage is worn for three to four days after ambulatory phlebectomy and compression stockings are worn for short periods after all treatments to assist in healing and reduce any mild discomfort or swelling that may occur. “I could see an improvement as soon as I was able to take off the bandages,” says Mr. Strode. His treatments were followed up about a month later with sclerotherapy. According to Dr. McHutchison, patients return for two post-procedure visits to assess
the efficacy of treatment and evaluate the patient’s healing response to the therapy. Often additional sclerotherapy, with or without ultrasound guidance, is performed to ensure the best long-term results. CAROLINA VEIN CENTER IS BORN So impressed was Dr. McHutchison with the treatment of her own veins and at the encouragement of her friend and colleague Dr Cynthia Shortell, she decided to specialize in phlebology. At the time, she was an obstetrician/gynecologist and her 12year practice at Kaiser Permanente in San Diego, Calif., involved managing varicose veins in her pregnant patients. Dr. McHutchison began her phlebology training at Duke University as an observational fellow with Dr. Shortell, who is chief of vascular surgery. Subsequently, she completed an extended clinical preceptorship with John Mauriello, M.D., fellow of the American College of Phlebology and nationally known educator in the field. JULY 2010
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