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Cycle of Care
To ensure you receive the highest level of care with long-lasting results, the medical experts at Vascular Vein Centers have established a six-step Cycle of Care. This treatment protocol has proven to be effective and is one of our vein center patient resources that allow us to obtain the best possible results in treating your venous disease. We diagram your vein problem in both legs on an anatomic chart, so you can follow the treatment plan along with our providers.
Our Cycle of Care was created to help you understand and follow your treatment process and ensure that you receive comprehensive care. During our Cycle of Care, we evaluate, diagnose, treat and follow-up your vein condition. This process ensures you receive comprehensive care for your vein disease to help restore leg health.
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— Margie Dilman
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The Vascular Vein Centers initial consultation includes a thorough assessment, including your leg symptoms and physical findings. We are careful to check your family and past medical history to see if there are any factors that might affect your treatment plan. Based on the provider's findings, a Doppler ultrasound may then be recommended for a complete evaluation of the venous system. Your insurance benefits will be verified for this procedure.
Insurance companies recognize treatment of saphenous reflux and varicose veins as a medical necessity if there are significant symptoms or signs. Most insurance companies require a period of three months of conservative therapy. This consists of the use of medical grade compression stockings, efforts at weight loss if that is a factor, periodic elevation of the legs, exercise and documentation of analgesic use for discomfort. If compression stockings have been worn previously, the conservative period may be eliminated.
If you are a cash patient or choose not to use your insurance benefits, the period of conservative treatment isn’t necessary and you may begin your treatment immediately. Spider veins and reticular veins are considered cosmetic and are not covered under insurance.
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A Doppler study of the superficial and deep venous system is necessary to rule out clots, or scarring from previous clots, document sources of reflux (back flow of blood that causes varicose veins) and determine the size of the diseased veins and the degree of reflux.
A portion of this examination is performed while you are standing in order to obtain the best assessment of the varicose veins because vein problems are worse with gravity’s forces in the standing position. You will be asked to discontinue use of compression stockings on the day of your test and will be asked to stand for a period of time before the examination to reproduce real-life circumstances.
Following the initial consultation and Doppler ultrasound scan, a treatment plan will be developed with you. If you have varicose veins and they meet your insurance company’s criteria for treatment, a period of conservative management will be initiated, unless compression hose have been worn. Although varicose vein therapy may be appropriate, many insurance carriers require you to meet strict guidelines to be eligible for reimbursement. In most cases, this consists of three months of conservative management, which includes wearing compression hose, potentially pursuing a weight loss program and taking analgesics for late day discomfort.
If your ultrasound is normal, you may schedule cosmetic sclerotherapy treatment. If you chose not to utilize insurance benefits for payment, treatment can begin immediately.
Endovenous Laser Therapy (EVLT) is the primary procedure used by Vascular Vein Centers for the treatment of vein disease. The 30-minute procedure is performed in one of our clinics and is extremely effective in treating saphenous and perforator veins. EVLT patients are generally very satisfied with their results and experience low reoccurrence rates with less post-operative discomfort than "vein-stripping."
Additional procedures, such as Ultrasound Guided Sclerotherapy, are usually required to complete treatment of the varicose vein branches. This 15-minute procedure is generally performed two weeks following a laser treatment, and multiple sessions are typically required.
During your post-treatment evaluation, Vascular Vein Centers’ providers use a Doppler 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 of spider veins or conservative follow-up. It is important to treat the underlying varicose veins first to ensure optimal results with cosmetic sclerotherapy or conservative follow-up.
Veins are controlled, not cured! It is important to have periodic follow-up evaluations to maintain healthy legs. Gravity, personal habits, hormones and time conspire to make normal veins varicose.
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