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Dr. Goodman is the first Vascular Surgeon in Western Massachusetts to be certified to perform Endovenous Laser Ablation (EVLT) and Radiofrequency VNUS Closure procedures for the treatment of varicose and spider veins.
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Did you know:
A vascular surgeon is the only trained physician with the
required training and experience to accurately diagnose and
treat you based on the examination of your venous and arterial
system, family history, medical history, medications and
appropriate diagnostics.
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Under local anesthesia and elective conscious sedation, the heat of a laser (Dornier MedTech - link to video) or radiofrequency device (VNUS Closure) is delivered through a tiny catheter that is inserted inside the affected leg vein. Under strict controls, energy is delivered as the catheter is withdrawn from the vein. The energy heats, collapses and seals the vein closed. Healthy veins take over and remove blood from your legs returning it to the heart. As normal flow is reestablished in the venous system, your symptoms will noticeably improve.
Patients walk out of the office wearing compression stockings and resume near normal activities that day. Frequent walking is encouraged. Strenuous exercise should be avoided for approximately one week.
Dr. Goodman uses one of the safest lasers on the market today. The Dornier Medilas Skin Pulse Diode 940 laser delivers pulsed or continuous laser delivery and has a Light Guided Protection System (LPS) for increased safety.
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Small to medium red veins called spider veins, or telangietasias, or blue veins called reticular veins, can easily be treated by using a very fine needle and injecting the vein with an FDA approved sclerosing agent, Sotradecol that causes the lining of the vein to close. The veins then shrink, break down and disappear. Compression stockings are worn for approximately one week to keep the vein collapsed. More Info..
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This procedure is very effective in the local treatment of larger, varicose veins and perforator veins. Perforator veins are those that can contribute to ulcers. Under ultrasound guidance and using a very fine needle, the solution is injected into the vein. The solution displaces blood, causing the vein wall to be irritated. The vein wall comes in direct contact with the solution, resulting in vein closure. The result is that the vein closes down without incisions on the skin.
Specific protocols for the concentrations of the sclerosant are maintained.
Solutions of normal saline are NOT used in our facility as the occurrence of severe burning and irreversible scarring are more common. |
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Ultrasound guided foam sclerotherapy is the latest development in the field of sclerotherapy and is used in longer and larger veins. The new points in this technique are that the liquid sclerosant is mixed with air in a syringe to produce foam. Ultrasound is used to locate the vein and the foam is then injected into the vein under direct ultrasound guidance. The foam displaces the blood permitting maximum strength of the sclerosing agent to be in direct contact with the vein wall. This irritates the vein wall causing the vein to collapse. The walls will then "scar-down", closing off the vein.
Very small spider veins that cannot be treated by sclerotherapy are easily treated by using the Dornier 940 laser. The wavelength is the perfect length for treating fine spider veins.
When the skin is adequately cooled, light energy from a laser is used to precisely target the spider vein, heating it and sealing it shut. They will naturally be absorbed by the body and will then disappear.
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Under local anesthesia, micro incisions are made to remove small and large varicose veins near the surface of the skin. It is often used in conjunction with ablation therapy. It is also effective in treating varicose veins of the foot. A compression stocking is worn for 1-2 weeks. Patients can return to normal daily activities, including work the next day. Walking is encouraged. |
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A minor surgical procedure where a large varicose vein is tied- off and removed. It is done under local anesthesia. Compression stockings are worn and ambulation is encouraged.
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The most conservative management for venous disease is wearing prescription strength, thigh-high compressions stockings. They need to be the tightest that you can comfortably tolerate to be effective. TED hose are not adequate to provide enough compression to reduce the swelling, pain, achey and tired feeling experienced at the end of the day. Compression stockings are worn after endovenous ablation, schlerotherapy, ambulatory phlebectomy, and vein stripping and ligation. The use of compression therapy is to control swelling and promote collapse of the treated vein.
* Most insurance companies require patients to wear prescription strength stockings for 1 to 6 months before they will consider coverage for treatment.
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At the end of the day, elevating your legs above the level of your heart (your toes higher than your nose) will facilitate the return of venous blood back to your heart. Take whatever breaks during the day as you can, walk as much as possible and elevate. Sitting and standing are the worst. |
- Limit sodium intake and do not smoke.
- Exercise daily - An active lifestyle is beneficial to your heart and longevity. Walking causes the calf muscles to contract and helps return the blood from out of your legs and back to your heart. Walking with compression stockings helps prevent excess fluid from building up after it is pumped out of your legs with walking.
Please check with your physician before beginning any excercise program.
- Weight Management
- Footwear-properly fitting, no high heals
- Limit restrictive clothing
- Avoid prolonged standing or sitting
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Due to the tremendous advancement of research and technology in the treatment of venous disease, the old-fashioned techniques requiring lengthy periods of bed rest and painful recuperations are long past. The standard post treatment regime consists of walking as much as possible in the days following each treatment. This regime helps to re-establish blood flow back to the heart through healthier veins. Compression stockings are worn for short periods after most treatments. This is crucial to assist with healing, reduce swelling and also promote blood flow back to the heart. Follow-up visits are scheduled to evaluate the efficacy of the procedures and to answer any question or concerns that you may have. The timing and frequency of follow-up visits will be determined by the procedure used. |
For more specific information, please visit the FAQs page or call the office to speak with one of our staff members.
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