The Top Vein Clinic Near Me: Our Vascular Surgeon Explains

The Top Vein Clinic Near Me: Our Vascular Surgeon Explains

The Top Vein Clinic Near Me: Our Vascular Surgeon Explains 150 150 daniadmin


There are few things as frustrating as spider and varicose veins.  Besides the unsightly appearance, these unnatural veins are the source of a multitude of symptoms including leg pain, leg heaviness, leg swelling and restless leg syndrome.  In more advanced cases, patients can also notice skin discoloration, leg ulcerations and bleeding varicose veins that can be quite alarming. Finding relief depends on knowing what to look for in a vein clinic.  This article is written by our expert vascular surgeon, Dr Brotman-O’Neill where she explains the attention to detail and resources the best vein clinics tend to offer.  Dr Brotman is the lead physician at our vein clinic in Princeton NJ.

What Causes Leg Pain From Varicose Veins?

It’s not uncommon for patients to be amazed by the symptoms that can be explained by varicose veins or better yet, venous insufficiency.  Venous insufficiency represents the underlying condition for many patients with symptomatic spider and varicose veins. In fact, eliminating surface veins alone without addressing the underlying problem often leads to recurrences and continued pain.

Many patients will describe the feelings they have as being different than pain, but more so discomfort, heaviness, or cramping.  These symptoms occur daily and get worse through the day as blood tends to pool in the legs from poor venous circulation. Importantly, this uncomfortable feeling does not often occur right over the location of visible varicose veins because it comes from below the surface.   And some patients will be found to have venous insufficiency in the absence of visible varicose or spider veins.

Leg circulation is impaired in chronic venous insufficiency due to elevated pressures within the leg veins.  As the pressure rises, the veins become dysfunctional and stretch leading to pain (discomfort) and inflammation.  The problem is somewhat unique to humans because we spend so much of our time standing (or where our legs are in a dependent position).  As such, leg veins have to do far more work than our veins in the hands, chest or head to return back to the heart. As the veins dilate, they cannot return to their normal size without proper diagnosis and treatment.


How Do You Diagnose Varicose Veins?

Proper evaluation of vein disease requires the expertise of a vein specialist.  Unlike medical spa clinics or dermatologists, vein clinics are dedicated to the diagnosis and treatment of all presentations of vein disease.  This includes common complaints such as spider veins and varicose veins, but also the more insidious symptoms of leg pain, leg heaviness and leg swelling that can accompany venous insufficiency.  Venous insufficiency is a medical condition and needs a complete history and physical with accompanying diagnostic ultrasound to make an accurate assessment and treatment plan. Venous insufficiency is also covered by insurance with medical necessity and is conveyed to your insurance carrier with proper documentation and ultrasound images.


What Is The Best Treatment For Varicose Veins?

A lot of this will depend on the evaluation from your vein doctor and testing results from the duplex ultrasound.  Patients are often characterized into one of three categories (overlap is common as patient will express cosmetic goals along with symptoms of vein disease):

  • Cosmetic: Patients without underlying venous insufficiency or symptoms.  Primary treatment goal is the elimination of spider and reticular veins using sclerotherapy or laser removal.
  • Symptomatic Venous Insufficiency: Patients will benefit from treatment for the underlying condition.  In the absence of leg ulcerations or swelling, the primary treatment is exercise, weight loss (if needed), and compression grade 2 medical stockings.  If conservative measures have not controlled symptoms, then medical treatments are evaluated
  • Advanced venous insufficiency: These patients present with further signs of vein disease (CEAP 4-6) which includes leg edema, stasis dermatitis, skin discoloration, or venous leg ulcerations.  Bleeding varicose veins are also a sign of advanced vein disease and compression stockings alone are likely to be insufficient for resolution of symptoms.

Premier vein clinics are accustomed to treating all varieties of vein disease and have the diagnostic tools to make an accurate assessment of your condition that matches the anatomy seen on ultrasound.  Over treatment is common in vein clinics where symptoms and ultrasound findings are not thoroughly examined. In such instances, patients are advised several unnecessary treatments without addressing the primary goals of the patient.  Our vein clinics are managed by board-certified vascular experts formally trained in endovascular medicine. Additionally, our ultrasounds are performed by certified techs and only interpreted by in-house registered vascular physicians (RPVI credentials).  This guarantees the highest quality of vein care.

What Is The Newest Treatment For Varicose Veins?

The most surprising fact to many patients seeking varicose vein removal is that surgery is not needed.   Modern vein treatments offer patients only minimally-invasive solutions resulting in no downtime, no scars, and virtually no pain.    Our favorite techniques are found at all the best vein clinics and are reviewed here:

  • Radiofrequency ablation: Catheter-based technology that delivers radiofrequency generated heat to the blood vessel walls.  The procedure is done with only small amounts of local anesthetic and can be completed in less than 30 minutes.
  • VenaSeal: This is the latest innovation in vein treatment and is equally effective as RF ablation.  VenaSeal is also a catheter-based technology. However, unlike ablation, the catheter is used to inject a medical adhesive that fuses the diseased vein closed. As such, it requires no tumescence for anesthesia.
  • Sclerotherapy: A medicated solution is injected in either liquid or aerated form (foam sclerotherapy). This medication acts as a sclerosant and disrupts the walls of diseased veins causing them to collapse and eventually be absorbed.
  • Ambulatory Phlebectomy: This requires the most skill and patience, but still is minimally invasive.  Tiny incisions are made over large, protuberant veins so that they can be directly removed.  Unlike stripping, these procedures are done within the office and patients do not require any downtime.  The best part, any large visible varicose veins are immediately removed leading to dramatic skin improvements.
  • Clarivein: Another catheter-based technique with some special uses in certain varicose vein anatomy.  In this case, mechanical force and sclerosant are used to eliminate diseased veins.

Why Princeton Vein Center?

The Princeton Vascular Center is a complete diagnostic and treatment center for both simple and complex vein disease.   Our training and experience is what sets us apart from other vein clinics in Princeton NJ where we offer the latest technologies in varicose vein treatment.  Our recognitions include NJ Top Doc, Castle Connolly Top Doctor, and Inside NJ Top Docs. Dr Brotman-O’Neill also serves as President Elect of the New Jersey Vascular Surgical Society.  She is a proud resident of Princeton and can often be seen running around the neighborhood and participating in half and full marathons.

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