Do you accept any insurance plans?
At this time we accept Health Net, Blue Shield and Blue Cross Blue Shield plans for medically necessary treatment. Please call our office for more information.
Do you offer financing?
In addition to major credit cards we also offer financing options. Click here to learn more.
What symptoms and complications can occur if varicose veins are left untreated?
Symptoms include leg tiredness, heaviness, aching, throbbing, restlessness, tingling, burning, itching, numbness, and swelling. Complications such as phlebitis, blood clots, dermatitis, bleeding, and stubborn open sores (“ulcers”) can occur if veins are left untreated.
But don’t we need all the veins we are born with?
Not in the legs. For every visible vein on your leg, there are many more under the skin. By sealing off the few abnormal veins from the many normal ones, the circulation is repaired and normalized.
What is sclerotherapy?
Sclerotherapy is the injection of small amounts of a special solution directly into unwanted veins. When performed properly, this collapses and shrinks the treated veins which are later reabsorbed by the body’s natural healing response. It is a brief office procedure which requires no anesthesia.
What is the success rate for sclerotherapy?
In expert hands, close to 90%. Like other technical procedures, more practice leads to improved results with less complications.
What about lasers for vein treatment?
Treatment of spider veins in the leg by means of a laser provides inconsistent and unpredictable results which often disappoint most patients. While effective for tiny cosmetic facial veins, lasers are significantly less effective on leg spider veins compared to expert sclerotherapy. However, newer endovenous lasers used to treat the source of large varicose veins have proven to be the most effective treatment available (see below).
Is sclerotherapy painful?
Because we use very small needles (30g), and because the solution we use does not cause intense burning like hypertonic saline, there is only minor discomfort. No anesthesia is required.
Is sclerotherapy safe for anyone?
The contraindications for sclerotherapy include: pregnancy, non-ambulatory status, allergy to the sclerosing agent, pre-existing blood clotting tendencies, and the inability or unwillingness to follow instructions.
After sclerotherapy, the patient must avoid vigorous aerobic activities, walk one hour daily, and wear compression stockings. This is only for several days after spider vein treatment, and 1 week after treatment for varicose veins (ultrasound-guided sclerotherapy, Varithena, and thermal ablation). These instructions are not necessary after VeinGogh.
What is the recuperative period?
There is none. The patient can return to work directly from the office and carry on with normal activities immediately.
How is ultrasound used to treat veins?
Duplex ultrasound imaging has emerged as the best way to locate the hidden diseased veins that flood the more obvious varicose veins on the skin surface; it also provides guidance for the precise injection and laser treatment of these abnormal veins, which otherwise would have to be surgically removed. VCOC is the first dedicated vein treatment center in Southern California to offer its own duplex ultrasound system equipped with “color-flow” technology for improved accuracy. As the first vein specialist in Orange County to perform ultrasound-guided sclerotherapy, Dr. Kanter has the most experience with this procedure in all of southern California.
Don’t some doctors treat just the bulging surface veins?
The older approach of treating just the visible surface veins is like trimming the leaves off a diseased branch instead of removing the branch; the leaves (veins in this case) will grow back, which is why this older method has been discarded by knowledgeable vein experts.
What about the new ultrasound-guided catheter-directed procedures?
More recently, catheters conducting laser or radio-frequency energy may be threaded into the deeper hidden diseased (“saphenous”) veins to shrink them down. These procedures have the highest success rate (greater than 95%) of any treatment method, including surgery. We are therefore happy to offer this second non-surgical option to treat large varicose veins in those patients proven to be qualified candidates by duplex at consultation. More information is available in the Endovenous Thermal Ablation section of this website, and also at VenaCure’s website (for laser).
What is Varithena and how does it work?
Varithena is a new FDA approved microfoam used for injection under ultrasound guidance. Although Dr. Kanter has been performing ultrasound-guided (liquid) injections since 1991 and foam injections since 2000 without incident, others have reported rare but serious adverse reactions from foam.
To preserve the simplicity of foam injections while eliminating the risk of adverse events, Varithena was developed for treating saphenous veins and their surface varicosities. Although the success rate for Varithena is slightly less than thermal ablation, it is an excellent choice for those who wish to keep risks at a minimum and avoid the inconvenience of multiple local anesthesia injections and premedication required for thermal ablation. Varithena is also an excellent choice for those patients who are not candidates for thermal ablation because they have segmental vein interruptions from previous treatment, small veins, or very tortuous veins. See our blogs on Varithena for more information and a chart comparing Varithena to thermal ablation and older forms of foam. Unfortunately the high cost of Varithena has kept it from being very popular.
Which is better laser or radiofrequency?
Both are highly effective and comparable. Newer higher wavelength lasers (>1300 nm) cause less discomfort during recovery.
What if a vein is needed later for by-pass surgery?
There are many other arm and leg veins available for donor grafts. Surgeons use these healthy veins for by-pass surgery instead of a diseased varicose vein.
If sclerotherapy didn’t work for me in the past, does that mean it never will?
If you have leaks from your ceiling when it rains, and you kept patching the ceiling without first repairing the source of the leak on the roof, you wouldn’t be surprised to find your ceiling kept springing leaks every time it rained. Likewise, as stated in the above answers regarding large varicose veins, one must first eliminate the underlying diseased veins which feed the bulging surface veins to obtain a durable result. This can be done by surgical removal, duplex-guided injection, or duplex-guided thermal ablation.
Does this also apply to spider veins?
In most cases, yes. However, for spider veins, the “feeding” veins are not deep. They are visible as larger, blue-green veins on the surface, similar to normal veins often visible along the arm. Many doctors performing sclerotherapy as a sideline either ignore or avoid treating these feeder leg veins.
Do you use saline for injection?
No. Although effective for small spider veins, concentrated salt (saline) solutions are very painful. Most Phlebologists (vein specialists) use other proven solutions that cause very little discomfort and work well for different size veins.
Does treatment “cure” large varicose veins?
Because previously normal leg veins can deteriorate over time, it is important to understand that varicose vein disease is a treatable, but incurable chronic condition. Accurate identification and elimination of all problem veins is the key to both initial control and subsequent periodic maintenance. When duplex ultrasound is used for pre-treatment mapping, the results of the best surgeons and best sclerotherapists will be similar. We therefore advise that the method of treatment a patient chooses (surgery, sclerotherapy, or endovenous laser) is less important than the choice of an experienced clinician who is an expert in his method of choice.
Should a woman wait to treat her varicose veins until after all planned pregnancies?
That would make as much sense as postponing treatment for diabetes or hypertension due to pregnancy. Treating any of these incurable chronic conditions, including varicose veins, serves to gain control of the condition, thereby limiting damage to the target organs from the normal physiologic stresses of pregnancy. Most phlebologists agree that treatment for varicose veins is best done before or between pregnancies. Just ask any woman who has suffered through pregnancy with painful varicose veins!
What about unsightly veins on the face, hands, or breasts?
Experienced phlebologists can successfully treat most cases of unwanted prominent veins on the face, hands, and breasts. Laser or VeinGogh is sometimes used in combination with sclerotherapy to treat the very fine red facial veins.
Does your office offer other cosmetic services such as liposuction, Botox, etc.?
No. We feel that by devoting our full attention to vein disorders, we can provide the best possible service in this area. As a result, we have performed more ultrasound-guided sclerotherapy treatments than anyone in Southern California, and have earned a reputation for excellence in phlebology. Perhaps this explains why the majority of our patients are referred to us by their doctors.