FAQ

  1. What can I expect from a free vein evaluation at Miller Vein?
  2. What is a new patient examination?
  3. What causes spider veins and varicose veins?
  4. What is venous reflux?
  5. What is venous insufficiency?
  6. Is there anything I can do to prevent venous insufficiency?
  7. Do you treat veins anywhere else besides the legs and face?
  8. Do men get varicose veins and spider veins?
  9. How common are varicose veins and venous insufficiency?
  10. Can varicose veins cause significant medical problems?
  11. When should I consult a doctor?
  12. Is vein therapy covered by insurance?
  13. Are all laser treatments equal?
  14. What are some of the current lasers for treating venous insufficiency?
  15. Is there a difference between radiofrequency ablation (VNUS ® ClosureFAST™ ) and laser treatments for varicose veins?
  16. How long does recovery take?
  17. How many return visits should I expect after a spider vein treatment?
  18. Is vein treatment safe during pregnancy?
  19. Is venous insufficiency related to restless leg syndrome? The symptoms sound similar.
  20. What is Deep Vein Thrombosis (DVT)?
  21. What is an interventional radiologist?
  22. What is a phlebologist?

What can I expect from a free vein evaluation at Miller Vein?

Enjoy your approximately 15 minute meet and greet with a board certified Miller Vein specialist who will determine if you have any of the clinical signs or symptoms of venous insufficiency. If so, we can schedule your full medical evaluation at your convenience.
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What is a new patient examination?

During a new patient exam a color duplex ultrasound exam will be performed. This allows us to assess the venous anatomy, vein valve function, and venous blood flow changes, and to firmly establish a diagnosis and create your treatment plan. Being cared for by an interventional radiologist with years of training and experience in the performance and interpretation of ultrasound is very advantageous. You deserve to always have your ultrasound reviewed by a Board Certified Radiologist. This ultrasound examination is thorough and includes assessment of both the deep and superficial venous systems. Your diagnosis and treatment plan will be discussed with youand any questions or concerns will be fully addressed. When you leave Miller Vein, you will realize you made the right choice for your vein care. If you like, following your initial consultation, Miller Vein will contact your insurance company and supply them with the necessary documentation to pre-certify you for treatment. The new patient exam takes roughly 1-1 ½ hours.
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What causes spider veins and varicose veins?

It is known that heredity, being female, pregnancy and age are the most common causes of spider veins. Other causes could be related to obesity, trauma and standing for long periods of time, but research is still ongoing to discover if these are definitive causes of spider veins and varicose veins.
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What is venous reflux?

Normally, veins in the lower extremities carry blood to the heart against gravity. This is accomplished by one-way valves, which allow blood to flow upwards while your muscles contract. When your muscles relax, the valves snap shut preventing blood to flow in the wrong direction (towards your feet).

When veins become weak and the valves in your veins become faulty, blood is allowed to flow in the wrong direction (towards your feet). This puts excess pressure on the vein walls, which causes them to expand further. This expansion causes the valves to be even more ineffective. The most common veins to reflux are called saphenous veins. Visible varicose and spider veins are typically branches coming off these veins.
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What is venous insufficiency?

Venous insufficiency is the medical condition in which the valves in the lower extremities do not function properly, causing a variety of symptoms (among them varicose and spider veins). Venous insufficiency is synonymous with venous reflux.
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Is there anything I can do to prevent venous insufficiency?

The most common cause of venous insufficiency is heredity. Other common risks include being female, multiple pregnancies and aging. Due to these various unpreventable causes, there is no scientifically proven prevention strategy for varicose veins or spider veins.
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Do you treat veins anywhere else besides the legs and face?

Miller Vein treats venous disorders anywhere on the body.
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Do men get varicose veins and spider veins?

Yes. However, women experience more vein problems than men mainly because of the unique additional risk factors for females, including estrogen levels and pregnancy.
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How common are varicose veins and venous insufficiency?

It has been estimated that approximately half of the U.S. population has venous disease. An estimated 40 percent of women and 25 percent of men will experience the symptoms of varicose veins. There are at least 80 million people in the U.S. with varicose veins and spider veins.
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Can varicose veins cause significant medical problems?

Although rare, left untreated chronic venous insufficiency may cause a variety of health concerns. Possible complications include:
Stasis pigmentation: Leaking of blood products into the skin may occur, resulting in damaged and discolored skin, which usually occurs around the ankles and lower legs.
Venous Eczema (also known as stasis dermatitis): The skin becomes dry and itchy. This may progress to blistering and a scaly appearance to the leg.

Venous Stasis Ulcers: Unhealthy skin (as described above) is predisposed to open sores known as venous stasis ulcers, which are difficult to treat, painful, and can bleed. Fortunately this is relatively rare.

Superficial Thrombophlebitis: Varicose veins may become inflamed and tender due to clotting.

1Bleeding: With minor trauma, varicose veins may bleed, sometimes profusely due to elevated pressure. As noted, venous stasis ulcers are predisposed to bleeding as well.
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When should I consult a doctor?

With safe, effective treatments readily available, you no longer need to suffer with varicose veins or spider veins. If you think you have a problem, you should consult a vein specialist. Even without the presence of varicose veins or spider veins, if you suffer from aching leg pain, fatigue/heaviness of the legs, or swelling and pruritus (itchy legs), you may be suffering from venous insufficiency. These symptoms usually get worse as the day progresses, and you may get some relief by elevating your legs. Other symptoms include restless legs, night cramps, and, in severe cases, skin color changes and bleeding skin ulcers.
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Is vein therapy covered by insurance?

Many insurance companies cover varicose vein treatment if the medical condition causes symptoms that limit activities of daily living. Insurance carriers may require a certain duration of conservative management that has failed including: wearing compression stockings, walking, avoidance of prolonged sitting or standing, frequent elevation of affected legs as well as the use of an anti-inflammatory medication. The knowledgeable staff of Miller Vein will assist you in understanding your benefits and, if you like, will seek pre-approval for your treatment. If your insurance carrier does not cover treatment, we will review fees with you, and arrange payment options. For your convenience, Miller Vein accepts major credit cards as well as providing CareCredit™
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Are all laser treatments equal?

All lasers are not created equal. While all of the lasers on the market attempt to damage the targeted vein wall in order to close it shut, the methods by which they do so differ. The first generation of lasers targeted the blood within veins, which resulted in excessive heat. Though the heated blood would eventually damage the vein wall as intended, the excessive heat caused tiny holes in the vein which then leaked blood and caused bruising. Newer laser systems such as CoolTouch CTEV™, Biolitec’s ELVeS® PL-1470nm Laser System and Total Vein Systems’ Thermalite™ 1470 directly target the water within the vein wall, causing it to shut close. Because these laser systems can do this with far less heat, there is much less bruising.
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What are some of the current lasers for treating venous insufficiency?

1320 nm Nd:YAG Laser
CoolTouch CTEV™ by New Star, Cool Touch
Diode Lasers
Total Vein Systems’ Thermalite™ 1470
Biolitec’s ELVeS® PL-1470nm Laser System
Venacure™ Laser Vein Treatment by Angiodynamics® Incorporated
EVLT® and the DELTA Laser by Diomed.
Vari-Lase Endovenous Laser System by Vascular Solutions, Inc.
Donrnier D940 Laser by Dornier MedTech
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Is there a difference between radiofrequency ablation (VNUS ® ClosureFAST™ ) and laser treatments for varicose veins?

Both methods work very well and have excellent results. The only difference is the type of energy used.
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How long does recovery take?

Immediately after a varicose vein treatment, you will be able to resume most normal activities; exceptions are heavy lifting, extreme exercise, and application of heat to the treated extremity. Usually you can resume heavy exercise in approximately two weeks. Complete recovery times vary from person to person. For spider vein treatment there is no significant recovery time and patients experience minimal if any bruising.
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How many return visits should I expect after a spider vein treatment?

The average spider vein patient requires anywhere from 3 to 6 treatments. However this will vary significantly from patient to patient based off of the severity of their individual situation.
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Is vein treatment safe during pregnancy?

We recommend avoiding vein treatments, while pregnant or if you are breastfeeding, since the procedures are elective and medications may be necessary. Additionally, we recommend waiting several months after pregnancy for treatment, since varicose veins may improve or resolve in that time.
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Is venous insufficiency related to restless leg syndrome? The symptoms sound similar.

Restless Leg Syndrome is a medical condition associated with the constant desire to move the limbs because of perceived unpleasant sensations in them. The symptoms can include itchiness, pain, throbbing, aching, fidgets, tearing, and a ‘creepy crawly’ sensation. From the vein world end, venous insufficiency is one cause (not the only cause) of restless legs and there is evidence that treating venous insufficiency can benefit many patients who suffer with restless legs.
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What is Deep Vein Thrombosis (DVT)?

Deep Vein Thrombosis refers to the formation of a blood clot (thrombus) in the deep veins of the body, most commonly the lower extremities. A thrombus may form as a result of a blood-clotting abnormality, an injury, or a period of prolonged inactivity (such as a long airplane ride or bed rest). One of the dangers of a DVT is that a thrombus can break loose and travel through the bloodstream to the lungs, resulting in a life-threatening pulmonary embolism. Another danger of DVT is known as post-thombotic syndrome. This occurs when the valves of the deep venous system are damaged, resulting in long-term symptoms including pain, swelling, and discoloration of the skin.

A person with deep vein thrombosis may or may not have symptoms. Symptoms include tenderness, pain, or swelling. Treatment usually includes the use of blood-thinning medications (anticoagulants) that prevent new clots from forming or prevent existing clots from getting larger. Newer catheter-directed therapies are available, including devices that remove clots, administer drugs directly into a clot, or both. Procedures of this kind typically are done by an interventional radiologist.
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What is an interventional radiologist?

Interventional radiologists are specially trained in performing minimally invasive treatments using imaging guidance. These highly trained physicians perform a wide variety of procedures, including opening up blocked arteries and veins with angioplasty balloons and stents. Conversely, if a person is bleeding, interventional radiologists can block up the bleeding vessels with catheters by injecting occluding materials (embolization). Vessels supplying uterine fibroids can be blocked, known as uterine fibroid embolization, which is a minimally invasive alternative to surgery. Interventional radiologists perform many different types of biopsies and abscess drainage procedures often helping patients avoid major surgeries. Newer techniques that are being performed and refined include the treatment of cancers by injecting chemotherapy agents directly in the blood vessels supplying tumors as well as devices that “burn” tumors, an interventional radiologist pioneered endovenous laser ablation for the treatment of venous insufficiency. For more information about interventional radiology please visit the Society of Interventional Radiology’s website at:http://www.sirweb.org/
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What is a phlebologist?

A phlebologist is a physician who specializes in the treatment of veins. For more information about phlebology please visit the American College of Phlebology’s website at: http://www.phlebology.org/
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