Tuesday, January 24, 2017

What is tumescent anesthesia?

Before we explain what tumescent anesthesia is, let’s talk about when it would be used in vein care.

Endovenous thermal ablation (using laser or radio frequency) is considered the gold standard in treatment of the great and small saphenous veins, two veins that are often the source of varicose veins in the lower leg.

Endovenous laser ablation (EVLA) uses laser energy to create an intense localized thermal reaction in the incompetent vein. The thermal energy causes vein to seal shut, stopping the healthy blood flow from entering the damaged vein. This keeps the blood flowing toward the heart, not allowing it to change directions and return to the feet. The body will reabsorb the damaged and treated vein, forcing the blood to be diverted to healthy veins in the leg.

EVLA is an outpatient, minimally invasive procedure performed with local anesthetic.

Part of the treatment involves tumescent anesthesia, a technique in which a high volume of a dilute local anesthetic is infiltrated around the vein. Tumescent anesthesia serves three purposes during thermal ablation. First, the fluid causes the vein walls to collapse around the thermal fiber maximizing contact. Second, the fluid creates an insulating ring around the vein and thermal energy source. This protects all surrounding tissues, including nerves and muscles, thus stopping any type of collateral damage. The third function is as an anesthetic, keeping the patient comfortable during the procedure. 

The introduction of tumescent anesthesia into the body should not be painful but can be when administered by some physicians. Thus, before any vein treatment, consult with a board certified phlebologist who can provide a full understanding of all aspects of the procedure.

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Tuesday, January 10, 2017

Are varicose veins a cosmetic issue or a medical issue?

This is a question we get at the Vein Healthcare Center all the time.  Most healthcare providers would agree that if a patient is having pain and is unable to perform his or her work due to varicose veins, then it is medically necessary.

But all factors must be weighed when drawing a line between medical and “simply cosmetic,” not the least of which is restoring patients’ confidence and overall well-being. Even if a patient isn’t experiencing physical pain – but won’t swim in a pool or wear shorts to the beach because he’s ashamed of varicose veins – her quality of life is markedly diminished.

Additionally, it is common for venous disorders to be undiagnosed or undertreated. It’s important to remember that varicose veins are a symptom of early stage venous disease, and if left untreated could lead to larger medical issues.

From the perspective of insurance companies the difference between “cosmetic” and “medical” may be whether or not a vein has a connection to the deep system; if it does and the connection is leaking, then they consider treatment medical necessary. That said, there are many vein procedures that are covered by insurance, and one should not assume that treatment won’t be covered. Feel free to contact us at VHC to discuss the details of your coverage.

At VHC, our basic philosophy is that treating problematic veins isn’t about vanity – it’s about health and quality of life.

If you’re not sure whether or not you have vein disease, click here to find out more.