FAQ
Questions on Endovenous laser treatment (EVLT)
What happens to the vein after it is closed off, or ablated by EVLT?
The vein that is treated by EVLT remains closed for the rest of your life, and as time passes, it gets absorbed to a certain extent by the body.
What happens to the blood flow when the long saphenous vein is shut off? Will other veins
take over?
The fact of the matter is that there are already other veins that are currently directing the blood flow back to the heart, because the refluxing veins are currently sending the venous blood back down the leg (when standing or sitting for a long time). When the abnormal vein is shut off, these other veins will have an easier time carrying the blood out of the leg.
Does EVLT require general anesthesia? Will I be awake or asleep?
An important innovation about the EVLT is that it can be performed with the patient awake. It does not require general anesthesia. It only requires local anesthesia, i.e. injections with lidocaine-containing solution. General anesthesia is a potentially dangerous undertaking for patients, and it is completely unnecessary for this procedure. In fact, we have performed over 2,000 EVLT’s in the past several years. We have never had to use anything more than local anesthesia to perform those procedures, even in the most anxious patients.
Will there be stitches after the procedure?
No stitches
How long does it take to do EVLT?
We do all our EVLT procedures in one-hour sessions. We have learned from performing over 2,000 procedures that one-hour is the optimal time for completing the procedure. Beyond one hour, there arises a greater chance of issues arising from patient’s back pain, hip pain, bladder incontinence, fatigue, etc. If you have very complex venous reflux anatomy where there are more than 2-3 veins that need to be treated, you may require two EVLT sessions.
Can you do both legs with EVLT at the same time?
For the same reason as above, we treat one leg at a time, ideally one month apart. Treating both legs in the same setting takes too much time and discomfort during the procedure. There is tissue trauma, post procedural pain and discomfort that follow each EVLT procedure, such that treating both legs simultaneously can be overwhelming for most patients.
How much does it hurt after EVLT?
There can be mild to moderate pain associated with post-procedural inflammation. We use a low-frequency laser technology to minimize post-procedural pain. Usually most patients tolerate pain with anti-inflammatory analgesics such as Ibuprofen alone.
How much time should I take off work following EVLT?
Time off from work depends on two things: (a) Degree of physical activity required in your job that would be a stress on the newly treated leg; (b) Your desire to return to work and your ability to endure mild to moderate pain/discomfort during work. If your job consists of low-level physical activity (e.g., office work), and if you are motivated to return to work (e.g., self-employed), you can return to work the following day. Even if your job requires moderate degree of physical activity (e.g., nurse or hair stylist), if you are able to tolerate mild to moderate discomfort (equivalent discomfort to a moderate cold or flu), then you can also return in 1-2 days.
If your job requires strenuous physical activity (e.g., construction work or mail-carrier) or if you are unable to tolerate mild or moderate discomfort well, then you should take off between 1-3 days plus the weekend and return to work the following Monday. If minimizing time-off from work is important to you, then you should let us know, and we will schedule your procedures accordingly to meet your needs.
How effective is EVLT?
The veins that we treat with EVLT will stay closed with a success rate of 95 to 98%, long-term. If your leg pain and discomfort are caused by venous insufficiency, then EVLT will result in significant improvement in pain and discomfort in over 80% of patients. If your concern is that of leg swelling, the following is what we have observed: After EVLT, the pain and discomfort and the “pressure” associated with your swelling in the leg will improve in greater than 80% of the time. But the “disappearance” of swelling will depend on the nature of your swelling, such as the cause of your leg swelling above and beyond the refluxing veins (such as obesity, heart/liver/kidney conditions, etc.), the duration of your leg swelling, etc. In some patients, the appearance of swelling does not return to normal even though the pain and discomfort is alleviated.
What is the chance that my varicose veins and leg symptoms will come back after EVLT?
The chance that the vein that was closed by EVLT will open again is less than 2-5% (1- 2% at the Advanced Vein Care Center). However, the chance that other veins in the leg will develop venous insufficiency because of on-going risk factors (hereditary, obesity, standing long periods), is about 25%. Venous insufficiency is a life-long condition, and it needs to be monitored by the patient, so that when the symptoms of pain and varicose veins return, you should seek help from the vein specialist right away.
Questions on damaged veins
What are the medical grade compression stockings?
Compression stockings/ socks are recommended to treat early stages of venous insufficiency. It helps to compress the lower leg and reduce swelling and relieve other symptoms of varicose veins. They come with different levels of compression and fitted by trained people. This reduces risks of DVT deep vein thrombosis and fastens the process of healing with increasing chances of healing.
When should I seek medical advice for damaged veins?
Conservative therapies can help reduce the risks of getting the condition worsen with damaged veins. You can try home care to improve the effect on symptoms. You can exercise, maintain healthy weight, elevate your legs, and wear compression stockings. When left untreated, varicose veins can result in sores, blood clots, ulcers, Deep Vein Thrombosis (DVT). Varicose veins should be treated as recommended by individual physicians to avoid complications in the future. As unpleasant as they can be, varicose veins can be easily treated. Having surgery is a better choice than the look of it to keep the veins healthy.
Questions on insurance & payment options
What types of insurance do you take?
We work hard to provide services to our clients with many different insurance providers. All the locations accept almost all the major insurances. It is best to give us a call to know more about our insurances for particular treatments. We would love to help our patients to answer their specific questions about insurance needs. Reach out to our locations to know more about insurances at 909.398.4895 and 909.309.0220
Does my insurance cover the vein treatments?
Most insurance companies do cover vein treatments for varicose veins that are medically necessary. In case of when conservative treatment few different therapies are being used some policies do not cover the treatments as these are viewed as only being done for cosmetic, not for medical reasons. Make an appointment for a consultation to get answers to more specific questions about your condition.
Questions on Ultrasound visit
What is vein ultrasound?
Venous ultrasound is a screening test that is a very safe procedure that is used for diagnosis of veins. This screening test observes not only superficial blood vessels in legs and arms but also deeper veins in any other areas. This helps you show the state of blood flow through the vessels in a particular area. It is a type of imaging that uses sound waves to create a detailed image of the particular part of the body. For venous insufficiency, ultrasound is the best imaging option as they show the soft tissues that x-ray can’t show.
What happens during the ultrasound session?
During a vein ultrasound, the targeted area appears on a monitor where you and our physician assistant can view that together. This procedure is not painful at all, occurs without using any radiation. A registered technologist will perform with a water soluble gel during the ultrasound exam.
The procedure is very safe and effective; proper screening for superficial thrombophlebitis is integral to a successful course of the procedure. The accurate imaging under the supervision of physician assistant/ vein specialist would lead to get the sources of the symptoms including pain, skin rash, redness or discoloration, leg or arm fatigue. In case of a serious condition like deep vein thrombosis in which blood clots might dislodge and travel to the lungs, appropriate care is required if the ultrasound confirms any blood clots.
How long does the ultrasound visit take?
Plan on dedicating around 25-40 mins for your ultrasound visit depending on the targeted area for study.
Why is ultrasound visit needed?
At FSA Vein, Dr. Yalamanchili or our physician assistants can use vein ultrasound to diagnose conditions of venous insufficiency, serious conditions like deep vein thrombosis. The ultrasound is constantly being used before and during the procedures to track the needle or catheter. It is an integral part of the vein removal process to get the accurate result throughout. Get in touch with Pomona or Rancho Cucamonga locations to learn more about vein ultrasound or procedures now!
Questions on Spider Veins
How many treatments do I need for spider veins?
We normally recommend patients a series of one - four treatments in order to achieve the best outcome. Patients with really mild spider veins may need just one – two sessions to achieve optimal results. The number of treatments varies with different numbers of spider veins to be treated and the targeted area.
What causes spider veins?
Spider veins can be caused by several factors. The following factors can increase a patient’s risk of developing spider veins, swollen veins:
How do you prevent Varicose Veins?
Varicose veins development can occur due to many reasons. Here are the ways to decrease the pain and symptoms of venous disorder and improve the overall health of veins.
What are the self-management techniques to deal with varicose veins?
It is better to let the vein specialist or vascular surgeon know about your condition and start getting the suitable treatment to get rid of varicose veins in the early stage. There are several self-management techniques to help you deal with varicose veins and decrease the symptoms of it including mild forms of exercises to improve the blood circulation in your legs. Mild Walking and cycling are better options to boost the blood flow in the legs. Stretch your legs and flex your calves more often, especially if you stand or sit all day for work. This will lead to reduction in bothersome symptoms. Elevate your legs at the end of the day and wear the recommended compression stockings.
Is cycling a good exercise for the patients suffering from varicose veins?
Cycling is one of the best methods of exercise to help reduce the symptoms associated with varicose veins and to build overall health of your legs. Any light activity that gets you on your feet can make a difference in the condition of venous insufficiency, cycling is a good option for the leg with vein issues for these reasons:
Can varicose veins be harmful?
Varicose veins can develop symptoms in the particular area. It can have many complications if left untreated. With other complications varicose veins may lead to:
What causes Varicose veins?
What are the basic signs and symptoms of varicose veins?
When left untreated, varicose veins can negatively impact the overall quality of life. Potential symptoms and risks include:
More serious risks include:
How do I spot a varicose vein?
Varicose veins are raised, large, swollen vascular vessels that appear twisted and turned through the skin’s surface. While they generally develop in the legs, they can appear on the face, as well.
What happens to the vein after it is closed off, or ablated by EVLT?
The vein that is treated by EVLT remains closed for the rest of your life, and as time passes, it gets absorbed to a certain extent by the body.
What happens to the blood flow when the long saphenous vein is shut off? Will other veins
take over?
The fact of the matter is that there are already other veins that are currently directing the blood flow back to the heart, because the refluxing veins are currently sending the venous blood back down the leg (when standing or sitting for a long time). When the abnormal vein is shut off, these other veins will have an easier time carrying the blood out of the leg.
Does EVLT require general anesthesia? Will I be awake or asleep?
An important innovation about the EVLT is that it can be performed with the patient awake. It does not require general anesthesia. It only requires local anesthesia, i.e. injections with lidocaine-containing solution. General anesthesia is a potentially dangerous undertaking for patients, and it is completely unnecessary for this procedure. In fact, we have performed over 2,000 EVLT’s in the past several years. We have never had to use anything more than local anesthesia to perform those procedures, even in the most anxious patients.
Will there be stitches after the procedure?
No stitches
How long does it take to do EVLT?
We do all our EVLT procedures in one-hour sessions. We have learned from performing over 2,000 procedures that one-hour is the optimal time for completing the procedure. Beyond one hour, there arises a greater chance of issues arising from patient’s back pain, hip pain, bladder incontinence, fatigue, etc. If you have very complex venous reflux anatomy where there are more than 2-3 veins that need to be treated, you may require two EVLT sessions.
Can you do both legs with EVLT at the same time?
For the same reason as above, we treat one leg at a time, ideally one month apart. Treating both legs in the same setting takes too much time and discomfort during the procedure. There is tissue trauma, post procedural pain and discomfort that follow each EVLT procedure, such that treating both legs simultaneously can be overwhelming for most patients.
How much does it hurt after EVLT?
There can be mild to moderate pain associated with post-procedural inflammation. We use a low-frequency laser technology to minimize post-procedural pain. Usually most patients tolerate pain with anti-inflammatory analgesics such as Ibuprofen alone.
How much time should I take off work following EVLT?
Time off from work depends on two things: (a) Degree of physical activity required in your job that would be a stress on the newly treated leg; (b) Your desire to return to work and your ability to endure mild to moderate pain/discomfort during work. If your job consists of low-level physical activity (e.g., office work), and if you are motivated to return to work (e.g., self-employed), you can return to work the following day. Even if your job requires moderate degree of physical activity (e.g., nurse or hair stylist), if you are able to tolerate mild to moderate discomfort (equivalent discomfort to a moderate cold or flu), then you can also return in 1-2 days.
If your job requires strenuous physical activity (e.g., construction work or mail-carrier) or if you are unable to tolerate mild or moderate discomfort well, then you should take off between 1-3 days plus the weekend and return to work the following Monday. If minimizing time-off from work is important to you, then you should let us know, and we will schedule your procedures accordingly to meet your needs.
How effective is EVLT?
The veins that we treat with EVLT will stay closed with a success rate of 95 to 98%, long-term. If your leg pain and discomfort are caused by venous insufficiency, then EVLT will result in significant improvement in pain and discomfort in over 80% of patients. If your concern is that of leg swelling, the following is what we have observed: After EVLT, the pain and discomfort and the “pressure” associated with your swelling in the leg will improve in greater than 80% of the time. But the “disappearance” of swelling will depend on the nature of your swelling, such as the cause of your leg swelling above and beyond the refluxing veins (such as obesity, heart/liver/kidney conditions, etc.), the duration of your leg swelling, etc. In some patients, the appearance of swelling does not return to normal even though the pain and discomfort is alleviated.
What is the chance that my varicose veins and leg symptoms will come back after EVLT?
The chance that the vein that was closed by EVLT will open again is less than 2-5% (1- 2% at the Advanced Vein Care Center). However, the chance that other veins in the leg will develop venous insufficiency because of on-going risk factors (hereditary, obesity, standing long periods), is about 25%. Venous insufficiency is a life-long condition, and it needs to be monitored by the patient, so that when the symptoms of pain and varicose veins return, you should seek help from the vein specialist right away.
Questions on damaged veins
What are the medical grade compression stockings?
Compression stockings/ socks are recommended to treat early stages of venous insufficiency. It helps to compress the lower leg and reduce swelling and relieve other symptoms of varicose veins. They come with different levels of compression and fitted by trained people. This reduces risks of DVT deep vein thrombosis and fastens the process of healing with increasing chances of healing.
When should I seek medical advice for damaged veins?
Conservative therapies can help reduce the risks of getting the condition worsen with damaged veins. You can try home care to improve the effect on symptoms. You can exercise, maintain healthy weight, elevate your legs, and wear compression stockings. When left untreated, varicose veins can result in sores, blood clots, ulcers, Deep Vein Thrombosis (DVT). Varicose veins should be treated as recommended by individual physicians to avoid complications in the future. As unpleasant as they can be, varicose veins can be easily treated. Having surgery is a better choice than the look of it to keep the veins healthy.
Questions on insurance & payment options
What types of insurance do you take?
We work hard to provide services to our clients with many different insurance providers. All the locations accept almost all the major insurances. It is best to give us a call to know more about our insurances for particular treatments. We would love to help our patients to answer their specific questions about insurance needs. Reach out to our locations to know more about insurances at 909.398.4895 and 909.309.0220
Does my insurance cover the vein treatments?
Most insurance companies do cover vein treatments for varicose veins that are medically necessary. In case of when conservative treatment few different therapies are being used some policies do not cover the treatments as these are viewed as only being done for cosmetic, not for medical reasons. Make an appointment for a consultation to get answers to more specific questions about your condition.
Questions on Ultrasound visit
What is vein ultrasound?
Venous ultrasound is a screening test that is a very safe procedure that is used for diagnosis of veins. This screening test observes not only superficial blood vessels in legs and arms but also deeper veins in any other areas. This helps you show the state of blood flow through the vessels in a particular area. It is a type of imaging that uses sound waves to create a detailed image of the particular part of the body. For venous insufficiency, ultrasound is the best imaging option as they show the soft tissues that x-ray can’t show.
What happens during the ultrasound session?
During a vein ultrasound, the targeted area appears on a monitor where you and our physician assistant can view that together. This procedure is not painful at all, occurs without using any radiation. A registered technologist will perform with a water soluble gel during the ultrasound exam.
The procedure is very safe and effective; proper screening for superficial thrombophlebitis is integral to a successful course of the procedure. The accurate imaging under the supervision of physician assistant/ vein specialist would lead to get the sources of the symptoms including pain, skin rash, redness or discoloration, leg or arm fatigue. In case of a serious condition like deep vein thrombosis in which blood clots might dislodge and travel to the lungs, appropriate care is required if the ultrasound confirms any blood clots.
How long does the ultrasound visit take?
Plan on dedicating around 25-40 mins for your ultrasound visit depending on the targeted area for study.
Why is ultrasound visit needed?
At FSA Vein, Dr. Yalamanchili or our physician assistants can use vein ultrasound to diagnose conditions of venous insufficiency, serious conditions like deep vein thrombosis. The ultrasound is constantly being used before and during the procedures to track the needle or catheter. It is an integral part of the vein removal process to get the accurate result throughout. Get in touch with Pomona or Rancho Cucamonga locations to learn more about vein ultrasound or procedures now!
Questions on Spider Veins
How many treatments do I need for spider veins?
We normally recommend patients a series of one - four treatments in order to achieve the best outcome. Patients with really mild spider veins may need just one – two sessions to achieve optimal results. The number of treatments varies with different numbers of spider veins to be treated and the targeted area.
What causes spider veins?
Spider veins can be caused by several factors. The following factors can increase a patient’s risk of developing spider veins, swollen veins:
- Pregnancy / hormonal changes
- Aging
- Heat/ Sun exposure
- Genetics
- Standing or sitting for long period of time
- Obesity
How do you prevent Varicose Veins?
Varicose veins development can occur due to many reasons. Here are the ways to decrease the pain and symptoms of venous disorder and improve the overall health of veins.
- Maintain a healthy weight
- Avoid taking medications which causes hormonal imbalance
- Wear compression stockings
- Low calorie diet, high fiber diet
- Exercise
- Elevate your legs
What are the self-management techniques to deal with varicose veins?
It is better to let the vein specialist or vascular surgeon know about your condition and start getting the suitable treatment to get rid of varicose veins in the early stage. There are several self-management techniques to help you deal with varicose veins and decrease the symptoms of it including mild forms of exercises to improve the blood circulation in your legs. Mild Walking and cycling are better options to boost the blood flow in the legs. Stretch your legs and flex your calves more often, especially if you stand or sit all day for work. This will lead to reduction in bothersome symptoms. Elevate your legs at the end of the day and wear the recommended compression stockings.
Is cycling a good exercise for the patients suffering from varicose veins?
Cycling is one of the best methods of exercise to help reduce the symptoms associated with varicose veins and to build overall health of your legs. Any light activity that gets you on your feet can make a difference in the condition of venous insufficiency, cycling is a good option for the leg with vein issues for these reasons:
- Helps to flex your calves⠀⠀⠀⠀⠀⠀⠀⠀⠀
- Pedaling is a good way to stimulate blood flow through legs⠀⠀⠀⠀⠀⠀⠀⠀⠀
- Strengthen your legs and improve circulation⠀⠀⠀⠀⠀⠀⠀⠀⠀
- In such cases, get a consultation and know about your condition better before trying any exercises
Can varicose veins be harmful?
Varicose veins can develop symptoms in the particular area. It can have many complications if left untreated. With other complications varicose veins may lead to:
- Discoloration in the leg/ ankle area
- Skin ulcer
- DVT (Deep vein thrombosis)
- Rupture and bleeding
What causes Varicose veins?
- Age
- Genetics
- Heavy lifting
- Prolonged standing/ sitting position
- Pregnancy
- Hormonal imbalance
- Obesity
What are the basic signs and symptoms of varicose veins?
When left untreated, varicose veins can negatively impact the overall quality of life. Potential symptoms and risks include:
- Increased inflammatory and clotting markers
- Discomfort
- Skin changes
- Ulcers
- Clots
- Deep vein thrombosis
- Burning sensations
- Cramping
- Restless legs
More serious risks include:
- Clots in deep veins that can travel to the lungs
- Venous ulcers that are very difficult to treat
How do I spot a varicose vein?
Varicose veins are raised, large, swollen vascular vessels that appear twisted and turned through the skin’s surface. While they generally develop in the legs, they can appear on the face, as well.
