Vein Care Plan

Your Six-Step Vein Care Plan will ensure you receive the highest level of care and long-term results.

STEP 1: Consultation

Your initial consultation will include a visit with the doctor. We will obtain a history regarding your vein symptoms and perform a thorough vascular physical examination.

Based on these findings, a duplex ultrasound may be recommended for a complete, more in-depth evaluation of the venous system. We will look for an underlying abnormality that may be causing your symptoms.

If you have been referred by another provider, a duplex ultrasound may have already been performed prior to your consultation.

Authorization for Treatment
Most insurance companies cover the treatment of saphenous vein reflux and varicose veins if there are significant symptoms. However, they do require 3–6 months of conservative therapy with compression stockings prior to treatment.

If you have significant symptoms or skin changes and varicose veins are identified, we will request authorization for treatment from your insurance company.

If you have no symptoms of underlying vein issues but have a cosmetic concern regarding your veins, you may schedule a cosmetic sclerotherapy procedure to alleviate your visible vein problems.

STEP 2: Diagnostic Ultrasound Imaging

A duplex study of the superficial and deep venous system is necessary to rule out superficial or deep vein blood clots, and to document sources of reflux (backflow of blood that causes varicose veins}. The study is performed by a Registered Vascular Technologist and interpreted by Dr. Pittman who will personally give you the results, usually on the same day.

The duplex study is painless and usually takes approximately 20-30 minutes. The study is sometimes performed while you are standing in order to obtain the best assessment of the varicose veins.

STEP 3: Education and Treatment Plan

Following the initial consultation and duplex ultrasound, the findings will be summarized and explained to you, and a treatment plan will be discussed.

If you have varicose veins and they meet your insurance company's criteria for treatment, a period of conservative therapy will be initiated unless you have already been wearing compression hose.

Although varicose vein treatment may be appropriate, many insurance carriers require you to meet strict guidelines to be eligible for reimbursement. In most cases, this consists of three to six months of conservative treatment including wearing compression hose, elevating your legs, pursuing a weight loss program, and taking analgesics for pain. If you chose not to utilize insurance benefits for payment, treatment can begin immediately.

If your ultrasound is normal, or if an ultrasound was not performed because you do not have significant symptoms, you may schedule a cosmetic sclerotherapy treatment, at your convenience.

STEP 4: Endovenous Ablation

Endovenous ablation (Venefit Procedure, previously called the Closure procedure or RF ablation [radiofrequency]) is the primary therapy used for the treatment of varicose veins.

The 30-minute procedure is performed in our clinic and is extremely effective in treating varicose veins caused by reflux. Patients are typically “in-and-out” and promptly resume normal activities, usually the following day.

After treatment, patients are usually very satisfied with their results. They report low recurrence rates, as well as less discomfort, less bruising, and fewer complications than with other forms of therapy.

An ultrasound is performed 1–4 days post­procedure.

STEP 5: Ultrasound Guided Sclerotherapy

Additional sessions, such as Ultrasound-Guided Sclerotherapy with or without foamed sclerosant (liquid medication) may be required to complete treatment of the varicose vein branches.

If these sessions are necessary, we will have to obtain prior authorization from your insurance company, if applicable.

STEP 6: Post-Treatment Evaluation

Your treatment is a process that may take up to 6-9 months to complete.

During your post-treatment evaluation, Dr. Pittman will again use a duplex ultrasound to evaluate the treated veins and determine if additional procedures are needed. Once your varicose veins have been successfully treated, you can begin treatment for spider veins. It is important to treat the underlying varicose veins first, to ensure the most optimum results.

It's important to note that varicose veins are treated, not cured. Periodic follow-up evaluations are necessary to maintain healthy legs.


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