Our treatment protocol is based on a variety of anatomical and physiological models. Our belief is that vein therapy should give long lasting solutions to circulation disorders. Below is our protocol in detail.

First Step: Deep Vein Ultrasound

The Deep Vein Ultrasound (DVU) is an initial evaluation of your lower extremities using none invasive ultrasound. This is to determine if you have VNUS reflux disease (“Reflux”). Reflux is when the vein or its valve’s do not work properly. When that occurs, blood pools in the lower part of the legs and does not return to the heart as well. PVCare believes that vein therapy may assist those with edema that is from a non-circulation condition as long as there is reflux disease in the lower extremities. Vein therapy has shown to be a necessary part of wound care as well as limb salvage. Some wounds are from arterial disease; however others are from venous reflux. Example is patient that has undergone abi and hyperbaric medicine that came to the clinic for wound care, however found to have significant reflux disease. The patient had treatment for both legs as well as TCOM measurements, graft placement, more hyperbaric, proper orthotics, return to exercising, helping himself.

Second Step: Endovascular Catheter Ablation Using Endoluminal Radiofrequency Heating (EVCA)

What? It means that vein is closed within your body using an ultrasound probe with no surgical stripping, sutures, or scarring. The entire procedure is performed through a single intravenous (IV) site. The basic premise of the procedure is that the ultrasound probe emits a heat pulse. This heat pulse melts the protein lining the vein. As the catheter is withdrawn, the vein is compressed and the protein acts like glue holding it shut. The leg is wrapped in a compression bandage to brace the vein together as the protein cools and remains closed. This technology is safe to use on patients that have experienced amputation, chronic wounds, acute wounds due to trauma, other circulation disorders such as atherosclerosis, and some hematological disorders in which there are vascular lesions.

Third Step: Phlebectomy

Phlebectomy is the removal of medium size veins from the skin surface. This entails small incisions ion the superficial skin layer and the removal of the vein using small, very specific instruments. The visible vein is tied at each end, excised, and removed. The incisions are not stitched and therefore scarring is minimal if visible at all.

Fourth Step: Sclerotherapy

Sclerotherapy is a treatment of small, visible veins using a solution that causes the vein to remain closed and then disappear. The solution itself is painless when introduced to the vein. After EVCA treatment, the veins present on the surface will remain on the skin because of the way the veins grew into the tissue. These veins will need to be removed to complete treatment, as the veins can become thrombosed, or clotted (phlebitis). They also become inflamed and painful. Once these vessels are removed, they will more than likely to never return. It is based on the anatomical aspect of the PVCare Protocol. If the smaller, surface veins are connected to a larger vein that has recently been closed, then where do they get their blood supply? Those veins do not have a blood and will simply remain in the skin. In the skin, those veins can do nothing other than clot or become inflamed. The use of sclerotherapy and YAG laser therapy has shown to be effective treatments for these small surface veins.

Fifth Step: Nd: YAG (Neodymium-doped yttrium aluminum garnet) Laser Treatment
 
Nd: YAG Laser Treatment (YLT) is a proven treatment for superficial veins, The treatments emit a laser pulse which causes the veins to remain closed and the disappear, much like sclerotherapy. The difference in the treatments is the YLT can remove veins in a non-invasive manner and can also treat much smaller veins that would be very difficult to access with sclerotherapy.

Once you have completed the above five options (if needed), we hope that you are satisfied with the results. It is PVCare’s policy that our service is not finished until the patient is completely satisfied with their care. Subsequent appointments are at one (1), (3), (6), and then twelve (12) months to determine the success of our treatment as well as your satisfaction.

Thank you for choosing PVCare as you vein, limb, and skin center.

New Life

"I have ankles again. The swelling had been so bad for many years that I thought there was no hope. Dr. Parisi has given me new life." A.C.

Read More

Hooray!!

"Between Dr. Parisi's procedure and the following up laser treatments, I can wear shorts again and not be embarrassed." L.S.

Read More