Vein & Laser Surgery : Richard York, M.D. in ludington MIVein Evaluation and Treatment Services:

We provide our patients with the highest quality services personalized for their unique needs.  ​Based on our years of experience involving thousands of patients, we have selected what we feel to be the best treatments currently available. Because we offer options from every treatment category currently available, we can utilize the single treatment or combination of treatments that are truly best for YOUR individual case! Please be aware that some hospitals, clinics, and physicians only offer one type of treatment. Although those treatments may be reasonable, they may not be the BEST option for your case!  All of our treatments are done on an outpatient basis at our office and NEVER require general anesthesia. In most cases you will be able to return to normal activity later the same day or by the following day.

Pre-Treatment Evaluation:
Partial or incomplete treatment rarely leads to good results. Therefore, all of our patients undergo a pre-treatment screening ultrasound evaluation using state-of-the-art diagnostic equipment to ensure they receive the most appropriate, complete, and successful treatment available. Please be aware that it literally takes years for vein problems to develop, and simply because you can’t see any large varicose veins on the surface of your skin does not guarantee they are not present and simply too deep to view without ultrasound. Therefore if you are considering treatment for ANY type of lower extremity vein problems, including spider veins, you should undergo an ultrasound screening evaluation first! If you are not checked, and it turns out you have an underlying large vein problem, you may be wasting your time and money on a treatment that never had a chance to work in the first place!  (Medical literature demonstrates that 30% of patients presenting with spider veins will be found to have underlying varicose veins!)

For Large Varicose Veins:
If you are found to have large varicose veins, you will be scheduled for a full diagnostic ultrasound venous flow mapping.  This diagnostic scan will fully evaluate all of the deep and superficial veins in your leg, definitively determine what is broken and what is normal, and show us the flow patterns and interconnections that we need to be aware of to determine the best individual plan of care for you. Please note that upright (standing) ultrasound venous flow mapping is now considered the pre-treatment standard of care and should be done prior to ALL treatments being planned for varicose veins.

Endovenous Laser:
 

This procedure has replaced surgical stripping for the treatment of the largest varicose veins.  A small laser fiber is inserted inside the vein under ultrasound-guidance and laser energy then seals the vein as the fiber is withdrawn. It takes about one hour and allows you to be back on your feet immediately after the procedure and back to work the next day.
 
Ambulatory Phlebectomy: 
This procedure is used for the treatment of large localized superficial branch veins.  The target vein is surgically removed through a series of tiny incisions so small they typically will not leave a scar.  It takes one to two hours and allows you to be back on your feet and back to work by the following day.

Sclerotherapy:

This procedure is used to treat the medium blue-green veins and small purple spider veins.  A series of injections are performed using a FDA approved detergent solution which causes the target veins to seal up.  Treatment is done in 30-60 minute sessions and you can return to normal activity immediately afterwards.

VEIN PROBLEMS:
Vein problems are very common. Besides the obvious cosmetic problems, varicose veins cause pain and suffering that limit activities and result in lost time from work.  By age 50, almost 40% of women and 20% of men have some significant vein disease.

VENOUS DISORDERS:
Varicose veins are large ropy blue veins under the skin, that can occur anywhere on the legs. They most often are the result of leaky (incompetent) valves in the superficial veins. When these valves no longer function properly, they allow blood to back up in skin veins. This causes high vein pressure, and in time makes the vein enlarge.  Swelling of the veins and surrounding tissue causes leg pain. This underlying valve problem must be corrected for a treatment to be successful. Some other related problems that are seen with long term varicose veins are;

    • STASIS DERMATITIS: Brown or reddish skin discoloration, with thickened skin, around the ankle and lower leg.
    • VENOUS ULCERS: Open wounds of the lower leg, most often near the ankle, that are difficult to heal without specialized care
    • SPIDER VEINS: Small blue or red blood vessels in the skin, ususally in clusters.
    • PHLEBITIS: occurs when one of the veins develops a clot. A painful, red lump in the region of a varicose vein is usually phlebitis.

DIAGNOSIS:
Each patient initially receives a thorough ultrasound evaluation of all of the major leg veins, performed by a well-trained and certified vascular ultrasonographer. The doctor then performs a physical examination, reviews the ultrasound results and correlates this with symptoms to precisely diagnose any vein disease. He then presents each patient with an individualized treatment plan.

TREATMENT:
The treatment of varicose veins and other vein disorders has advanced significantly in recent years. Previously, vein-stripping surgery was required, which involved General Anesthesia in a hospital, with numerous incisions and a relatively long recovery period. Since the introduction of endovenous laser ablation (ELA) the major diseased vein is eliminated through a single site, using a laser. There is minimal discomfort and bruising as compared to before. The laser destroys the vein lining, causing it to shrink down. Blood flow through the abnormal vein is thus stopped almost instantly, and skin vein blood flow now diverts to deeper normal veins. This also corrects the high pressure in other abnormal superficial veins, allowing them to shrink down as well.

Microphlebectomy & Sclerotherapy:
Sometimes additional treatments are used in special cases. Microphlebectomy can remove extra clusters of large varicosities, done with special instruments through tiny “needle-hole” nicks. Smaller “spider veins” can be treated by sclerotherapy, injecting a special sclerosant solution through a very fine needle, at the site of these tiny but quite visible veins. All of these treatments are performed as an outpatient, using some sedatives and local anesthesia. No stitches are required, and patients are able to walk and be active immediately, although intermittent leg elevation is advised for the 1st 24 hours.