Identification and Diagnosis
Varicose Veins are distended, ropey veins that are painful and cause swelling. These veins can leak fluid and cause inflammation possibly leading to ulceration. On your initial visit, Dr Hamon will examine you and determine if your disease is medical or cosmetic. This does not imply that “cosmetic” patients are in less discomfort than “medical” patients but does have implications in terms of reimbursement by insurance companies. Dr Hamon will examine your legs and order tests. Often an ultrasound is performed in the office by Dr Hamon in order to more rapidly identify the problem. He has had extra training in vascular ultrasound in order to do this exam properly. Effective treatment of venous insufficiency starts with accurate mapping of the venous system. Duplex studies are performed with the patient standing. This is critical and cannot be over-emphasized. While it is widely believed that these studies can be performed with the patient inclined at a 45 degree angle, our experience shows that diagnostic capabilities are dramatically improved when the patient is scanned in the standing position. Pinpointing the problematic vessels is critical to success of treatment, and scanning the legs while the patient stands is important in this regard. We have found that in many cases, even the cosmetically annoying spider veins are the result of insufficiency.
Once the pathology is mapped and its nature clearly identified, treatment options are determined. In patients whose varicosities are less than 2.4 cm in diameter with curvatures of less than 90 degrees, endovascular saphenous obliteration therapy can usually be performed successfully under local anesthesia. Patients are home the same day and back to work within a few days. This outpatient procedure has been successfully applied and largely replaced traditional vein stripping in many areas of the country, even for patients with significant varicosities.