341 Greeno Rd N, Suite B, Fairhope, AL 36532
 
 
 
 
 
 
 
 
 

Procedures

At Fairhope Vein we offer many different procedures. After the initial consultation, we will create a personalized plan that will fit the needs of every patient.
 
 
Color Duplex Ultrasound Examination of the Lower Extremities

This ultrasound mapping exam is significantly different than a DVT study. We examine the deep and superficial veins noting their size, flow, waveform, and reflux. All of these components are combined to create a map of the venous system which documents flow direction, and quantitative measurement of any problems in the deep or superficial systems. Venous waveforms can indicate cardiac disease, AV fistulas, Pulmonary HTN, and proximal obstruction (Iliac or IVC).

Indications- Symptoms suggestive of venous disease.
Contraindications- none
 
Endovenous Laser Ablation (EVLA)

This procedure is used to treat large varicose veins that are causing symptoms. It has virtually replaced traditional "stripping" procedures. In vein stripping, when a vein is found to not be working properly, the vein is physically removed so that blood will flow through other normally functioning veins. With EVLA, the refluxing vein is accessed under ultrasound guidance and a catheter is placed inside the vein. The laser fiber is then directed through the catheter and the tip is positioned with ultrasound guidance. A dilute anesthetic solution is then injected up the leg around the target vein to provide anesthesia, and to protect the surrounding tissue from heat. The laser fiber is then activated and withdrawn slowly. The heat from the laser destroys the inner layer of the vein, and flow is immediately stopped. Only one vein can be treated per appointment. The whole procedure takes about one hour. There are no stitches, and the patient can drive themselves home and resume activities immediately. For anxious patients, oral medications or Nitrous Oxide is available.

Indications- Symptomatic reflux in truncal veins.
Contraindications: Pregnancy, not ambulatory, active DVT or STP, PVD, hypercoagulable state, and tortuous or obstructed vein.

Venaseal Closure System

This procedure is used to treat large varicose veins. An adhesive is used to close the non-functioning vein, instead of heat like the EVLA procedure. A small incision is made and a catheter is placed inside the target vein with ultrasound guidance. No tumescent anesthesia is needed, meaning much less needle sticks when compared to EVLA's. Once the adhesive is administered, pressure is held on the vein to seal the vein together and stop the flow immediately. Multiple veins can be treated at one appointment. This procedure time varies depending on how many veins are being treated, but typically takes about an hour/hour and a half. Unfortunately, this procedure is not yet covered by health insurance. It is the procedure of choice for people that do not have time for multiple appointments, are afraid of needles, do not have health insurance, or have really high deductibles.

Indications- Symptomatic reflux in truncal veins.
Contraindications: Pregnancy, not ambulatory, active DVT or STP, PVD, hypercoagulable state, and tortuous or obstructed vein
 
 
Ultrasound-guided foam sclerotherapy (USGS)

This procedure is used to close symptomatic nonfunctioning varicose veins. It is useful for large tortuous veins. A solution is mixed with air and agitated into a foam to be injected into the target veins. The vein is accessed with ultrasound guidance, and the foam is injected into the vein. The solution irritates the lining of the targeted vessels and closes the vein. Foam sclerotherapy is much more potent than liquid sclerotherapy since it displaces the blood from the vein. The foam is also easily visualized on ultrasound and the flow of the foam can be tracked and guided with the ultrasound probe. Multiple veins can be treated in one visit. These appointments typically take about 30 minutes. Use of sclerotherapy can cause hyperpigmentation (dark discoloration) of the skin over the treated veins. If this occurs patients must keep these areas out of the sun. If the dark areas get tanned they could leave a permanent stain on the skin. Most discolored areas will fade over time if they are not tanned.

Indications- Large non functioning veins, partially occluded veins where a laser cannot be advanced, perforating veins, venous hemorrhage sites, and veins that have failed treatment with liquid sclerotherapy.
Contraindications- Pregnancy, active DVT or STP, Hx TIA, known PDA or other right to left shunt, non-ambulatory, and migraine with neurological problems.
 
 
Liquid Sclerotherapy

This procedure is used to close symptomatic non-functioning varicose veins. It is especially useful for veins that are close to the skin surface. A liquid solution is injected into the target veins under direct visualization, or with ultrasound guidance. Liquid solutions are typically used for smaller veins, and can be in multiple concentrations depending on the vein size. There are fewer neurological side effects and less staining of the skin when compared to foam sclerotherapy. This solution is used over foam sclerotherapy, if the patient has migraines.

Indications- Refluxing tributaries, and superficial varicose veins.
Contraindications- Non-ambulatory, pregnancy, and active DVT or STP

Micro-phlebectomy

This procedure is used to remove superficial varicose veins. The target veins are marked on the skin surface, the skin is then cleaned and prepped, by injecting a local anesthetic around the vein. Small incisions are made over the vein using scalpel. A "vein hook" is then inserted through the incision and the vein is removed. This method is more time consuming initially but the superficial veins are gone immediately. There are small scars after the procedure, but they are often less noticeable than the hyperpigmentation that can result from sclerotherapy.

Indications- Superficial varicose veins.
Contraindications- Pregnancy, history of uncontrolled hemorrhage, and non-ambulatory status.

Medical Therapy

There are some patients who are found to have significant venous disease whom are poor candidates for procedures, or do not want to undergo a procedure. We can treat these patients with conservative treatment utilizing compression (graduated compression stockings or Intermittent Compression Devices), lifestyle modifications, and medications (herbal or Rx).
 
Frequently Asked Questions

Q: How do I know if I need vein treatment?
A: If you are having leg problems, but are unsure if they are related to your veins call and make an appointment for a free screening so that we can go over your symptoms and determine if further evaluation would be helpful.

Q: Does insurance cover these procedures?
A: If you are having symptoms related to a vein disorder; pain, swelling, skin discoloration, Restless Leg Syndrome, ulcers, cramps, itching or bleeding varicose veins, most insurance companies will cover the initial ultrasound mapping and exam. If the initial mapping is abnormal, further evaluation and treatment will be covered. Prior authorizations will be obtained before any procedures are performed so that you will know what will be covered and what will be billed to you.

Q: What if I do not get my varicose veins treated?
A: Varicose veins and venous disorders are progressive diseases. If left untreated over time your signs and symptoms may get worse. The skin near your ankles may become discolored, the veins may bleed, sores may form that heal poorly or blood clots may result.
 
 
ASK THE DOCTOR
Dr. Sirk is always in. Feel free to submit your personal questions.
 
 
 
Before and After  — Blockage in Fairhope, AL