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Treatment FAQs

Dr. Elias trains British surgeon Dr. Rutter

1. I’ve heard that in the past most treatments involved general anesthesia, surgical incisions and long recovery times. Have things changed?

Yes, the nature of medicine is to continue to progress. In the last 10-years minimally invasive vein treatments have been developed with better results compared to “vein stripping” etc. Dr. Elias has been involved since the mid 1990’s with the development and teaching of most minimally invasive vein procedures. He continues to evaluate new devices, the most recent being ClariVein™. He was the first in the world to use this device in humans.

2. What are some of the advantages of Minimally Invasive Vein Surgeries (MIVS)?

Most are performed with local anesthesia, maybe some mild sedation. None require general anesthesia. Procedure time is short 20-30 minutes and patients can walk out of the office or procedure room almost immediately. Dr. Elias encourages his patients to resume full activity the next day including exercise as tolerated. Post procedure pain in minimal and usually requires at most Extra Strength Tylenol, Motrin, Advil etc.

3. Are surgical incisions still necessary for the minimally invasive procedures?

Almost all procedures are performed through a small needle stick or incision measuring 2-3 millimeters. Usually no sutures (stitches) are required.

4. What are my options for minimally invasive vein surgery?

The options depend upon which veins are functioning abnormally as diagnosed with ultrasound (see diagnosis section). They may range from laser, radiofrequency, or chemical methods to the use of balloons or stents for bigger vein problems. Some of the procedure names are: Closure™, EVLT™, TriVex, Mini phlebectomy, PAPS, Sclerotherapy, etc.

5. How does the vein specialist (Phlebologist) decide which is the best option for my vein problems?

The veins in the leg consist of 3 types: superficial, perforator, and deep veins. The superficial veins are the ones you can see; spider veins, bulging varicose veins, reticular veins. The deep veins are the main veins and they are within your muscles. The perforating veins connect the superficial and deep veins. Treatment is determined according to which veins are abnormal and what you (the patient) want to accomplish.

6. How successful are treatments?

Most patient’s feel they are at least 75- 80% improved after treatment. We cannot achieve perfection but with the right option you will see and feel a very significant difference. If you are looking for perfection, perhaps you should reconsider any treatment. Setting goals and realistic expectations is part of the discussion with your Phlebologist.

7. What about treating blood clots?

The standard treatment for blood clots in your main vein is anticoagulation (blood thinners) and they are still used. However, there are new minimally invasive devices that dissolve the blood clots in a matter of hours or a day or so as compared to the months required with blood thinners alone. By dissolving the blood clot sooner the veins suffer less damage and function better in the future. If you develop a blood clot you should seek the expertise of a vein specialist to see if you are a candidate for early clot removal.

8. Why should I seek evaluation by Dr. Elias?

Dr. Elias has over 15 years of experience with all minimally invasive vein procedures and has developed and improved many of them. He not only performs these procedures but teaches them to physicians who come to train with him at the Centers for Vein Disease from throughout the country and the world.