Varicose Veins

What are the steps of a varicose vein treatment at Medicus?

1. Complimentary Consultation

During the consultation, your questions will be answered by Dr. Steven Tidwell and will determine if you have varicose or spider veins.

2. Ultrasound Diagnosis

If you have varicose veins, an ultrasound will be performed by Dr. Steven Tidwell. After the ultrasound, he will be able to recommend the best treatment option for your unique case.

3. Vein Treatment

Treatment is scheduled following your ultrasound. Each of the varicose vein procedures are minimally invasive and allows for zero downtime. If you have health insurance, we will handle all of the insurance claims for you.

4. Follow-up Visits

You will see the doctor for a follow-up visit after your treatment for an ultrasound to ensure closure of the treated vein.

What are varicose veins?

Veins that have become bulging, elongated, thickened and rope-like are called varicose veins. Normally, one-way valves in veins keep blood flowing against the force of gravity. When the valves do not perform their function, blood can flow backwards or reflux within the vein. They usually occur near the surface of the skin and appear as bulging veins with a purplish hue.

Varicose veins can develop through a combination of these faulty vein valves and weakened vein walls. Under a variety of circumstances, normally toned, elastic vein walls can become weak and allow the recirculating blood to flow backward in the vein causing the blood to pool and the vein to bulge.

What are the symptoms of varicose veins and venous insufficiency?

Symptoms include aching, throbbing, fatigue, itching, tingling and heaviness – all of which worsen as the day goes on. Mild swelling in the ankles and feet often occur. Many people find that they need to sit down in the afternoon and elevate their legs to relieve symptoms.

People who have venous insufficiency can have symptoms even without visible varicose veins.

How are vein problems diagnosed?

An Interventional Radiologist can assess your clinical situation through an ultrasound evaluation. The ultrasound is important because it determines which veins are not functioning properly and allows the physician to create a "game plan" to present you with your best treatment option.

Why does Dr. Tidwell perform every ultrasound at Medicus Veincare?

Board Certified Diagnostic Radiologists such as Dr. Tidwell are specifically trained in ultrasound imaging during their four-year residency training program. His post-graduate fellowship in vascular and interventional procedures allowed him to expand his expertise with the vascular system and its irregularities, and he combines those skills to accurately diagnose and treat varicosities. An ultrasound technologist does not have this training, or diagnostic ability.

Patients should be aware that since an ultrasound is required not only for the initial diagnosis of varicose veins, it is also an integral part of the procedures that eliminate them. It is important to choose a physician who relies on his own training and experience to accurately determine the underlying cause of symptoms, and treat them with familiarity and expertise.

How are varicose veins treated?

Using an ultrasound, Dr. Steven Tidwell maps out the veins in your leg to pinpoint the faulty vein that needs to be treated. To treat this faulty vein, he inserts a very small probe using an ultrasound to follow and guide it to the proper position. He will then remove the probe, sealing the vein with either thermal energy or a surgical-grade glue.

What is Interventional Radiology?

Interventional Radiologists are specialized doctors who specialize in minimally invasive, targeted treatments performed using imaging for guidance. Many conditions that once required surgery can be treated less invasively by Interventional Radiologists with vein treatments that offer less risk, less pain and less recovery time. They have the ability to access the abnormal veins and navigate through their twists and turns – skills that are developed in Diagnostic and Interventional Radiology training.

Interventional Radiology is a recognized medical specialty by the American Board of Medical Specialties. These specialized radiologists are certified by the American Board of Radiology.

What is venous insufficiency?

The reflux of blood in faulty veins result in what is known as venous insufficiency, a very common condition that results in the pooling of blood in the vein and, in turn, creates varicose veins.

Is the loss of a vein a problem?

Not at all. The blood flow of the faulty veins are already being diverted to the many normal veins in the leg.

Is there any downtime?

No, there is no downtime associated with any of the vein procedures. You can go back to your normal activities right away. Each of the treatment modalities are minimally-invasive and do not require any sedation, only local anesthetic.

What happens if I leave my varicose veins untreated?

Varicose veins are a result of vein disease and will only continue to get worse if left untreated. Some patients progress to develop skin changes and ulcerations, in addition to swelling and discomfort.

Venous leg ulcers form when the varicose veins push against the surface of the skin, allowing the skin to become thin over time and break down.

Is there anesthesia involved with the treatment?

No, only local anesthetic is used. Patients find the discomfort from the procedures are minimal and some even fall asleep during the procedure. The procedures allow for zero downtime and you can return to your normal activities immediately after treatment.

Do I need to wear compression stockings?

Yes, you will need to wear compression stockings for up to two weeks after treatment to ensure complete closure of the vein. We sell many styles and colors of compression stockings to suit your lifestyle.

However, the VenaSeal glue procedure does not require the use of compression stockings.

Does my insurance cover treatment for varicose veins?

Yes, the treatment for varicose veins is considered medically necessary by insurance companies. Our insurance specialists will process all claims and will follow-up with your insurance company as necessary. After your consultation, we will advise you by phone or email of any deductibles, copays or co-insurance amounts that you may owe. If you do not have health insurance, we offer a cash rate.

We accept most major insurance companies including: Aetna, Blue Cross Blue Shield (Florida Blue), Cigna, Coventry, Medicare, Multiplan (BeechStreet, PHCS) and United Healthcare. If your insurance company is not listed, please call us. We may participate with your specific insurance plan.

Health insurance does not yet cover the VenaSeal glue procedure. Please contact us regarding pricing for this treatment.

Spider Veins

Why should I choose Medicus for spider vein treatment?

As vein specialists, Dr. Steven Tidwell and his board-certified Nurse Practitioner have the skill and latest technology at hand to treat varying cases of spider veins, including reticular, or "feeder" veins.

Reticular veins are the larger blue veins that often "feed" the spider veins and are eliminated using foam sclerotherapy. If previously treated spider veins are stubborn and seem to not go away, injecting the reticular veins will eliminate the spider veins at the source. Sometimes, an ultrasound is needed to see these reticular veins if they are not visible under the surface of the skin. As a board-certified Diagnostic Radiologist, Steven Tidwell, M.D. is specifically trained on ultrasound diagnostics and performs all of his own ultrasounds without the need for a separate ultrasound technologist.

Utilizing a combination of sclerotherapy (including ultrasound-guided sclerotherapy), VeinWave™, and cutaneous laser therapy, if needed, the professionals provide Medicus patients with optimal results normally not attainable with only one type of treatment.

Of course, patients need to keep in mind that with the exception of VeinWave™, all therapies require more than one treatment for optimal results.

What are Spider Veins?

Spider Veins, or Telangiectasias, are small, dilated or broken segments of blood vessel visible through the skin, often seen in a clustered pattern known as “spider veins.”

Hypertonic saline vs. Polidocanol for sclerotherapy?

We use FDA-approved Polidocanol for the sclerotherapy treatments. While the efficacy is the same, hypertonic saline (heavy salt water) is not used because it cannot be made into a foam to inject the reticular (feeder) veins and small varicosities for ultrasound-guided sclerotherapy. Polidocanol is more versatile than hypertonic saline and is more comfortable for the patient; it does not sting when injected.

How long does it take for the spider veins to go away after treatment?

Depending on how large the spider veins are, they typically go away within 2-4 weeks and may require more than one treatment using sclerotherapy or cutaneous laser treatments.

When using VeinWave™(used for the small spider veins typically found on the face or ankles), they disappear almost instantaneously after only one or two treatments. However, not all spider veins are candidates for VeinWave.

Are facial veins able to be removed?

Yes, the VeinWave™ treatment is specifically made for the small spider veins commonly found around the face including the nose and cheeks. Using microwave energy, the Veinwave procedure will eliminate these small veins in one to two treatments.

Are veins in the hand able to be treated?

Yes, veins in the hand can be treated by injecting a sclerosant into the vein, also known as sclerotherapy.

We also recommend injecting a dermal filler into the hand to improve the appearance of these veins without actually removing them.

Do insurance companies cover the cost of spider vein treatments?

Insurance companies do not cover the cost of spider vein treatments because they are considered cosmetic procedures.

If ultrasound-guided sclerotherapy is necessary for small varicosities to be injected, these treatments are covered by insurance companies.