Endovenous Ablation. Endovenous Ablation- Radiofrequency  is one advanced method. Minimally invasive technique is used and the procedure is done in an outpatient office and ambulatory setting. A tiny catheter is inserted in the bad vein after local numbing for a pain free  procedure from start to end. Then, the tip of the catheter delivers heat to the vein wall to take care of the refluxing vein. Blood then turns to the healthy veins to continue its journey back to the heart.  Vein specialist covers the tiny incision and gives a few recommendations to the patient. Patient is instructed   to wear compression stocking for a few days to aid in the results and prevent heavy lifting and exercises while recovering. However, patient usually return to work same day or next day because normal activities and walking is encouraged. Patient should return for follow up ultrasound imaging between 3 to 7 days after.

VenaSeal. This developed procedure is an even more advanced method of treating reflux: VenaSeal. The technology does not use heat to target the refluxing vein, but instead uses an adhesive to seal. Because heat is not used, compression stockings are not required after the procedure and numbing is only local at the start without the necessity to keep numbing the area until the end. Only one stick for numbing at the beginning of the procedure and no more. Follow up with ultrasound imaging is also done at 3 to 7 days after.

Advanced Sclerotherapy. This procedure is sometimes used in combination with the rest of the procedures to target small and tiny branches called tributaries of the refluxing veins. Ultrasound is used to guide the vein specialist to inject special medication that will take care of these so the blood keeps returning back to the heart through the healthy channels instead of going back. Compression stocking is recommended for 1 week after advanced sclerotherapy.

Ambulatory Phlebectomy. This procedure is also sometimes used in combination or by itself to target tortuous branches close to the skin that have not disappeared after treating reflux. It is done by making one or more tiny incision in the skin and extracting the refluxing branch. Local numbing is used to reduce discomfort and the use of compression stocking is required. But rapid recovery is anticipated for this minimally invasive procedure.

Advanced procedures and conservative management. Vein Institute in New York and New Jersey home for specialists in venous and pain management target Chronic Venous Insufficiency and Varicose Veins with expertise. Different procedures and combination of procedures are used depending on the case as well as managing conservatively if it is advised.

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