Great question. I’m glad you asked. Many vascular surgical groups do fine work in the diagnosis and treatment of peripheral arterial disease, carotid arterial disease, and abdominal aortic aneurysms, but often approach venous reflux disease as a peripheral (pardon the pun) aspect of their clinical practice. As a result, they will often focus on the catheter-based techniques that are useful in treating the refluxing great and small saphenous veins, but not focus on the diagnosis and treatment of associated refluxing accessory and tributary veins, which are often treated with ultrasound-guided foam sclerotherapy or endovenous laser.
If the patient only undergoes procedures that treat the refluxing great and small saphenous veins, the patient will often be left with significant residual symptoms of their chronic venous insufficiency, as they have only been “partially treated”.
At CVR, we pride ourselves on performing complete bilateral venous ultrasound in the standing position in order to identify ALL the refluxing veins that are responsible for the patient’s clinical presentation. In addition, whenever possible, we also perform visual sclerotherapy on the residual spider veins that often also contribute to the patient’s symptoms. Furthermore, our detailed 1 month and 6 month follow-up consultations, which include standing venous ultrasound, often identify additional underlying venous reflux disease that has been “unmasked” with prior treatment or has appeared since the initial evaluation.
Finally, because we are a large physician-owned group (25 centers and counting) that focuses SPECIFICALLY on the treatment of symptomatic venous insufficiency, we have accumulated and published clinically-significant data on the best treatment algorithms for these patients.