2. What is PHLEBOLOGY?

3. Anatomy review
Deep vein system vs. Superficial vein system

4. Why veins fail

5. Risk factors for venous insufficiency
Genetics
Gender
Ethnicity
Lifestyle
Occupation
Aging
Ankle motility

6. What to look for and when to refer
Spider veins
Varicose veins
Heaviness
Aching
Swelling
Throbbing
Fatigue
Cramping
Burning
Restless legs
Changes in the skin and/or wounds that won’t heal A B C D
A) Swollen
B) Varicosities
C) Hemosiderin Staining
D) Spider Veins

7. Questions to ask your patients

8. Common complaints I hear from patients

9. Brief overview of modalities to treat venous insufficiency
Compression Therapy
Endovenous Laser Ablation (EVLA)
Sclerotherapy (ultrasound and light-assisted)

10. Compression Therapy

11. Endovenous Laser Ablation

12. Sclerotherapy

13. Ultrasound-Guided Sclerotherapy

14. Light-Assisted Sclerotherapy

15. Questions my vein patients always ask me

16. Why treat spider veins and varicose veins?
50-year-old woman with aching, cramping, throbbing, swelling, itching, heaviness in her legs bilaterally
EVLA treatment and one session of sclerotherapy
Relief from her symptoms

17. Why treat spider veins and varicose veins?
Physically fit 59-year-old man was bothered by the appearance of his bulging varicosities
Two sessions of sclerotherapy
— Give your P.A. POV of why being aware of the symptoms of venous insufficiency is important.
— Prevent problems down the line (skin breakdown and ulcers)
— It makes a patient’s body feel better; it’s amazing how much your legs affect your health and wellbeing.
— It makes your patient’s mind and spirit feel better; it can be a great relief to be able to “wear shorts again” without feeling self-conscious or embarrassed.

18. Why treat spider veins and varicose veins?
72-year-old woman presented with symptoms of venous disease, including aching and cramping
EVLA procedure with follow-up appointments at two and six months
Required no further treatment

19. Why treat spider veins and varicose veins?
45-year-old woman’s symptoms — aching, cramping, pain, heaviness, and numbness in her legs — started when she became pregnant more than two decades earlier
Two EVLA treatments and multiple sessions of sclerotherapy
All of her symptoms were alleviated

20. Why treat spider veins and varicose veins?
70-year-old man with a long history of swelling in all of his extremities, with more significant edema in his left leg
Suffered with Milroy’s disease since birth
EVLA treatment
Swelling decreased — plus cramping and itching — and he is now walking comfortably

21. Why treat spider veins and varicose veins?
65-year-old woman sought help because of veins in her right leg
Upon evaluation we saw that both legs were affected — and the disease was worse in her left leg
EVLA treatment on both legs, followed by ultrasound-guided sclerotherapy

22. Why do I love treating veins?