Vein History and Medical Necessity Form
Pre Procedure Review Sheet
Initial visit ...
On your first visit to Vanguard Vein Center we recommend that you wear or bring along a pair of
shorts so we are able to evaluate your leg veins. If you download the vein history and medical necessity form you
will be able to save some time in our waiting room. A complete patient history is necessary for a thorough
evaluation. You will meet our office staff and physician to review your medical issues and create a plan of care.
Most patients with varicose veins will require a venous ultrasound of their leg(s). This ultrasound provides a
roadmap of your veins. This roadmap is paramount in determining the optimal treatment of your veins. This study
is non-invasive, and is performed in the standing position by placing a painless transonic gel on your skin, and
then a probe is placed on your leg. This probe can look through your skin to find the reason you have your varicose
veins and will guide us in determining which technology will be best for you.
Once your ultrasound is complete
you will be re-evaluated by our surgeon. He will review the results of your ultrasound and then discuss which
procedure will be best for you. The risks, benefits, and treatment options of the planned procedure will be
addressed in detail. Our doctors and staff understand that patients have many questions regarding their condition
and treatment. We are happy to spend the time necessary so you can feel comfortable with your treatment options.
We encourage you to contact us for more information or if you have any questions at any time during the course of
your evaluation and treatment.
During treatment ...
On the day of your procedure, your leg will be prepped with a Hibiclens solution (to cleanse the skin of bacteria)
. Next, your doctor will use ultrasound to locate the incompetent (leaking) vein and to confirm the position of the
catheter. He will then inject a small amount of lidocaine just around your knee over the area of the diseased vein
to numb the area so you will not feel him insert the catheter.
Next, a special solution called tumescent
that has numbing medication mixed in it will be injected along the course of the vein. There will be some
discomfort that most people describe as stinging. Your doctor will then turn on the laser, which causes
closure of the troublesome vein. This only takes a few minutes. At the end of the procedure, you will be put in
a compression stocking and an ace wrap will be placed around your thigh to provide support. You should be ready
to go home within 15 - 30 minutes after the procedure.
You will need to return to the office in three
to four days for an ultrasound examination of the treated vein.
Sometimes, patients may need additional
procedures to achieve optimal results. Other treatments may include phlebectomy (removal of branches of the
vein through very tiny incisions) and/or sclerotherapy (injection of a sclerosing medication directly into the
veins to close them off). We will usually wait until after the laser ablation procedure and see how much
improvement occurs before scheduling any additional procedures since many patients do not require any additional
Results of Laser Vein Treatments
Laser vein treatments have been performed in the
United States for over 7 years in thousands of patients with excellent success. Multiple clinical trials
have demonstrated the safety and effectiveness of this procedure in the short term and long term. This
procedure has been shown to be more effective than vein stripping with significantly less discomfort and
less recovery. We have personally performed laser or Radiofrequency closure of varicose veins in hundreds
of patients with greater than 95% success and no major complications over the last 5 years.
of patients do experience bruising and discomfort (described as aching, burning or pulling) along the treated
vein segment in the thigh. This typically resolves within 1 to 3 weeks without long-term problems.
Superficial phlebitis is uncommon but can cause inflammation and discomfort for several weeks and is
treated with over-the-counter mediations. Skin burns are extremely rare and have not been seen in our
practice. Blood clots are possible but fortunately occur less than 1% of the time. When clots do occur,
they are treated with a blood thinner called Lovenox, usually for several weeks.