Sclerotherapy 101

Sclerotherapy is used to treat veins just below the skin's surface that are either invisible or difficult to see with the naked eye. In this procedure, tiny needles provide access to the vein and then a substance called a sclerosing agent is injected into the vein's interior wall. This substance causes the vein to become sticky and seal shut, and the troublesome vein disappears. Blood then finds a healthy path back to the heart. There is little risk of complication, and patients often experience an immediate relief of symptoms. 

There are two ways that providers visualize the veins during this procedure: “ultrasound guided” and “light assisted.” Ultrasound-guided sclerotherapy uses ultrasound to locate veins that are not readily visible and cannot be seen with a light. This procedure is often used to treat perforator veins, or veins that connect the superficial system (above the muscles in your leg) to the deep system (veins under and between the muscles of the leg).  

During light-assisted sclerotherapy, a small, hand-held light illuminates the veins and tissue directly below the skin, which allows the provider to clearly identify the source of the dysfunction.

The number and length of each treatment vary from patient to patient. Each session can take between 15 minutes and one hour, depending on the complexity of vein patterns and venous reflux. Most patients need multiple treatments (3-6 sessions, on average), however, there is usually improvement with each session.

Here is the question that patients ask the most: “Will it hurt?” Everyone’s experience is different, but most people describe the feeling as quick little bee stings. It is always possible to stop the procedure or take a break if someone does find it very uncomfortable, but most patients say it is very tolerable. The medicine is pH balanced and vein access is with a 27-32g needle, so it’s just a very small perceivable pinch.

Immediately following the procedure, there may be mild itching of the legs, which typically resolves within an hour. For the next few days, there may be some tenderness and bruising. About two weeks following the procedure, there may be hard bumps in the area of the treated vein, which usually disappear over the course of several months.

The most common side effects are bruising and tenderness of the treated veins. The bruising is usually fully resolved within two weeks, and the tenderness responds well to heat and elevation. Remember, patients who follow the post-procedure guidelines for care will promote the most effective healing. Compression stockings should be worn for 7-14 days after each sclerotherapy session, depending on the severity of the venous disease.

The changes that patients notice in the first two months are improvement in symptoms. Patients have reported to that their legs feel lighter or pain free! The large, lumpy veins slowly disappear, usually 2-6 months after the procedure, and the smaller veins may disappear over the following six months. It’s good to remember that as the veins resolve, there may be some color changes in the skin; legs sometimes look worse before they look better. But when they look better, they look great!

To learn more about Sclerotherapy or other vein treatments, contact us at the Vein Healthcare Center today to schedule an evaluation. Education is the first step toward healthy legs!

Put Spring in your step!

For most of our patients, their main goal is to make their legs feel better -- but after vein treatment, we’ve heard many folks say that their legs look better too.

As summer approaches (a.k.a. shorts and skirts season) it can be emotionally difficult for those with visible veins on their legs to enjoy their time out and about. At the Vein Healthcare Center, our philosophy is that patients who want to treat their problematic veins aren't being vain; they want to improve their health and quality of life. 

While the appearance of spider veins and varicose veins is a common concern, the physical symptoms often take the biggest toll. If you suffer from vein disease, you may already know the familiar aching, throbbing, heaviness, and swelling that can affect your legs by the end of the day. What you might not realize is that the summer heat can actually exacerbate these physical symptoms. As temperatures rise, our veins naturally dilate to help cool the body down. For compromised veins, this extra dilation leads to increased pooling of blood, making that heavy, achy feeling even more pronounced during the warmer months.

This is why addressing your venous health before the peak of summer can be beneficial. Timing your treatment in the spring offers a few advantages:

• Comfort During Recovery: Following most vein procedures, patients are advised to wear prescription compression stockings for a short period to aid in healing and healthy blood flow. That can be a bit more comfortable in the spring -- especially spring in Maine!
• Time for Results to Show: While today's minimally invasive treatments require virtually no downtime, it takes some time for minor bruising to fade. 
• A More Active Summer: By treating the root cause of your discomfort now, you can jump back into hiking, walking the beach, and traveling with renewed energy.

You don’t have to spend another summer hiding behind long pants, making excuses to stay out of the water, or skipping out on the activities you love. Modern vein treatments are safe and effective. All procedures are performed right in our office and allow you to return to your normal routine almost immediately.

Take the first step toward healthier, happier legs. Contact us at the Vein Healthcare Center today to schedule an evaluation, and let us help you step into summer with confidence!

March is Blood Clot Awareness Month

 

Blood clots affect up to 900,000 Americans each year — and of that number, up to 100,000 lives are lost. Despite their prevalence, blood clots are frequently missed or diagnosed too late, in part because symptoms can be subtle, unexpected, or mistaken for other conditions. Increasing awareness helps people recognize warning signs sooner, ask the right questions, and take timely action — all of which can save lives.

Each March, the National Blood Clot Alliance observes Blood Clot Awareness Month to raise awareness about blood clots. Their theme this year is Strong Enough to Ask – A Campaign to Stop the Clot, which reframes strength as self-advocacy. The campaign focuses recognizing when something doesn’t feel right, trusting your instincts, and speaking up before a blood clot becomes life-threatening.

What is a blood clot?
A blood clot is a gel-like mass of blood that forms in a vein or artery. While clots play an important role in stopping bleeding after injury, they can also form when they aren’t needed. These abnormal clots can block blood flow and lead to serious conditions such as deep vein thrombosis (DVT) and pulmonary embolism (PE).

Who can get a blood clot?
Blood clots can affect anyone, regardless of age, ethnicity, race, gender, or activity level. However, certain health conditions, life events, and situations can increase risk. Knowing your personal risk factors can help you recognize symptoms sooner and speak up when something doesn’t feel right.

Other risks, including a family history of blood clots, people 55 or older, injury or trauma, and estrogen-based contraception or hormone therapy. Long-term diseases, such as heart conditions or diabetes are also risk factors. You can take a risk assessment here.

Signs and symptoms
Common signs and symptoms of a DVT include swelling, usually in one leg (or arm); pain or tenderness not caused by injury; reddish or bluish skin discoloration; and/or skin that is warm to the touch. Contact your doctor as soon as possible if you have any of these DVT symptoms.

Common signs and symptoms of a PE include shortness of breath; chest pain that’s sharp; faster than normal or irregular heartbeat; unexplained cough, sometimes with blood; and/or low blood pressure or lightheadedness. Call 9-1-1 immediately if you experience any of these PE symptoms.

Click here for more signs and symptoms of blood clots in greater detail.

Learn more about blood clots
To learn more about blood clots -- including how to spot and prevent them -- go to the StoptheClot website. If you have any questions about DVT, you're welcome to contact the Vein Healthcare Center.

Lipedema: Shedding Light on a Misunderstood Disease

 

In our latest issue of Vein Health News, we explore a condition called lipedema. Though it’s not venous in nature, there is often a co-occurrence with venous issues and sometimes lymphedema.

Lipedema is a loose connective tissue disorder that results in an abnormal buildup of adipose (fat) cells in the limbs. These cells settle into certain areas of the body, most often in the hips and legs—disproportionately more significantly than in the upper body (although lipedema sometimes affects the arms and lower trunk). 

 

Someone with lipedema may experience pain, tenderness, swelling, or easy bruising of the affected areas. The intensity and frequency of pain can vary. The condition may be accompanied by an unusual lumpy or fibrous texture within the fat tissue that can feel like peas or walnuts beneath the surface of the skin.

 

Lipedema is estimated to affect 10 to 17 million people in the United States, primarily women. The true prevalence is likely higher due to widespread underdiagnosis. The good news is that in 2021, a group of experts in the U.S. released a “consensus guideline” to standardize care for this diagnosis. Evolving scientific research is helping to increase knowledge of and about the condition.

 

There is currently no cure for lipedema. Current treatment means management, which includes dietary changes (to reduce inflammation), exercise, compression, weight loss (for management of comorbid metabolic disease), Manual Lymphatic Drainage (MLD), pain management, physical therapy, and in some cases, surgery.

 

Treatment for comorbidities can sometimes help. For example,
treating underlying venous insufficiency is appropriate if it is contributing to lower leg symptoms that impair functioning.

 

At the Vein Healthcare Center, we see a number of patients who have lipedema, and we do everything we can to provide knowledge to understand the condition. Having lipedema can be physically painful, not to mention difficult to cope with emotionally. That’s why psychological and social support are just as important as physical treatment.

Click here to read the Lipedema issue of Vein Health News!

3 reasons why winter is a great time for vein treatment

Diagnosing and treating varicose veins (and other forms of venous disease like spider veins and leg ulcers) is a good idea any time of year. Winter, however, is an excellent time for vein treatment. 

Here are just a few reasons why:

1. Cozy Compression

With a vein procedure such as ablation, you will be required to wear medical-grade compression stockings any time you are on your feet for the first two weeks following treatment. (After sclerotherapy, you should wear compression 7-14 days when you are on your feet.) The good news is that post-procedure compression stockings will keep you warm while you recover – and it’s much more comfortable with a winter wardrobe.

2. Less Swelling, More Comfort

Heat causes blood vessels to expand, or vasodilate, which can increase swelling and discomfort in legs that are prone to varicose veins. The cold weather naturally constricts blood vessels, which can potentially reduce post-procedure swelling and makes recovery feel easier than in the summer heat.

3. Ready for Summer 

Recovery from vein treatments take time. Patients can expect some amount of bruising, swelling, and tenderness, although post-procedure discomfort is highly variable from person to person. While some patients may experience discomfort, some may feel none at all. It takes time for legs to recover from vein treatment. If you get started in the winter months, you’ll be more ready for shorts in the summer.

If you’re concerned about your vein health and want to schedule an appointment this winter, feel free to contact us at the Vein Healthcare Center. Our goals are to learn about your condition, help you understand how your vein health affects your overall health, and provide you with treatment options. We make taking the first step simple, comfortable, and stress-free!

Be aware of DVT and travel safely this summer

Summer may be BBQ season, but it’s also the time when people travel long distances in planes, trains, and automobiles. For us in vein healthcare, that means increased risks of Deep Vein Thombosis, or DVT.

The deep vein system carries about 80% of blood from the feet back up to the heart. Deep veins are located under the muscle and connective tissue layers in the legs. A blood clot in a deep vein can be dangerous because the high pressure in the system could cause the clot to break free from the vein wall and enter the blood stream. The DVT could then travel up through the legs into another part of the body such as the lungs, where it would become a pulmonary embolism (PE).

DVT or PE symptoms are often misinterpreted as something less serious. A blood clot in the leg may feel like a “charley horse,” shin splints, or a twisted ankle. Symptoms from PE are often attributed to a pulled muscle in the chest, costochondritis (inflammation of the joint between ribs and breast bone), asthma, or a “touch of pneumonia.”

So what are some of the signs to look for? For DVT, the leg may be warm to the touch; swelling in the leg (can also occur in the arm); leg (or arm) pain or tenderness; reddish or bluish skin discoloration.

For PE, be aware of a sudden shortness of breath; sharp, stabbing chest pain (may get worse with deep breath); rapid heart rate or breathing; feeling lightheaded or fainting; unexplained coughing, sometimes with bloody mucus.

In half of DVT and PE cases, no symptoms present at all—but both conditions are medical emergencies. Any of these symptoms should be regarded as a DVT or PE until proven otherwise, especially if someone is in a risk category (including whether there is a history of blood clots in your family).

Awareness is key-- and so is prevention. When traveling long distances, stay well hydrated, stretch legs your legs and pump your feet periodically, avoid or moderate alcohol and caffeine, and consider wearing graduated compression stockings on your trip.

To find out more about DVT and other vein issues, contact us at the Vein Healthcare Center. We will evaluate your vein health — including spider veins, varicose veins, and leg ulcers.

Meet Dr. V!

Dr. Cindy Asbjornsen and the staff are proud to welcome Dr. Satish Vayuvegula to the Vein Healthcare Center team!

Dr. Vayuvegula (pronounced vye-VAY-gla), MD, MS, FAVLS, DABVLM has been a close colleague of Dr. Asbjornsen’s for almost 15 years. He is Board certified in both Phlebology and Emergency Medicine and has 20 years of experience diagnosing and treating venous disease. 

Dr. Vayuvegula earned his medical degree from The Chicago Medical School in 1999 and completed his residency at Emory University School of Medicine and Affiliated Hospitals of Atlanta, Georgia. 

After residency, Dr. Vayuvegula was invited to train in venous techniques. His interest in vein disease began during his residency when he learned that he had varicose vein disease. He underwent a thermal ablation and immediately experienced a dramatic improvement in his quality of life.

Since becoming certified by the American Venous &  Lymphatic Society, Dr. Vayuvegula has performed thousands of thermal ablations and vein procedures. He has been an active member of the American Vein & Lymphatic Society and the American Medical Association since 2005. He became an AVLS Board member in 2018, Secretary in 2020, Treasurer in 2021, and was named President-Elect in 2022 and he most recently was a co-author on two multi-society national guidelines publications on the treatment of venous disorders.

When not helping patients, Dr. Vayuvegula loves spending time with his family and traveling. He also enjoys playing golf, tennis, and pickleball.