St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Ryan Pereira DPM FACFAS
Anastasia Medical Group 

Discover the Latest in Varicose Vein Treatment


February 1, 2017 | View PDF

A Solution to Leg Pain

Have you taken a look at your legs lately?

If you don't like what you see then, at the Centre for Advanced Vein Care, Dr. Ryan Pereira and Dr. David Ross are who can relieve your painful symptoms and improve the appearance of your legs to restore them to a more youthful look!

What is Radiofrequency Endovenous ablation?

There are several options in the treatment of varicose veins. They involve Endovenous ablation, vein stripping and ligation, phlebectomy and sclerotherapy. For the purposes of this article I will focus on endovenous ablation treatment. Varicose vein treatment with endovenous ablation, is the latest minimally invasive treatment that uses radiofrequency energy to cauterize (burn) and close abnormally enlarged veins in the legs, a condition called venous insufficiency. Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves, which allow blood to return from the legs against gravity. If the valves leak, blood pools in leg veins, which can become enlarged or varicose. Endovenous ablation is an ultrasound guided procedure that uses heat generated by radiofrequency energy to close off these faulty vessels, diverting blood flow immediately to nearby healthy veins.

What are some common uses of the procedure?

Although this procedure may be used for cosmetic purposes, it is more commonly used to help alleviate symptoms associated with venous insufficiency. Leg pain, fatigue, tiredness, heaviness, aching, burning, itching, and restless legs are common symptoms of venous insufficiency. These symptoms often worsen with long periods of standing and can lead to leg swelling, throbbing and leg cramps. Conservative treatments include heavy support stockings, anti-inflammatory medications, and leg elevation. Venous disease is not as yet curable; however with appropriate treatment, the progressive nature of vein disease can be slowed and controlled

How is the procedure performed?

Dr. Pereira and Dr. Ross will numb the area where the catheter will enter into the abnormal vein with an anesthetic solution, and use the ultrasound probe to study the vein and track its path. The leg being treated is then cleaned, sterilized and covered with a surgical drape. A very small nick is made in the skin at the site. Using ultrasound guidance, the catheter is inserted through the skin into the vein and positioned within the abnormal vein. The radiofrequency electrode is inserted through the catheter and placed into the 'safe zone.' The local anesthetic solution is injected around the abnormal vein with ultrasound guidance. Radiofrequency energy is applied as the catheter is withdrawn 7 cm every 20 seconds. The skin is then covered with a bandage. No sutures are needed. This procedure is usually completed within 45 minutes.

Following the procedure, you will need to wear a gradient compression stocking to help reduce bruising, tenderness, and minimize the very rare possibility that blood clots may form. You may resume your normal activity immediately, with the exception of air travel or prolonged sitting (such as a long car trip). The physicians will perform a

follow up ultrasound examination in order to assess the treated vein. Within Additional procedures (such as sclerotherapy or ambulatory phlebectomy) may be necessary to treat the smaller associated vein and are finishing touches to make your legs beautiful and

youthful once again!

What are the benefits of this procedure?

Benefits are . . .

• No surgical incision is needed-only a small nick in the skin that does not have to be stitched closed.

• When compared with traditional vein stripping techniques, endovenous ablation is more effective, has fewer complications, and is associated with much less pain during recovery.

• Endovenous ablation is generally complication-free and safe.

• This procedure leaves virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions.

• Endovenous ablation offers a less invasive alternative to standard surgery.

• Most of the veins treated are effectively invisible even to ultrasound 6-12 months after the procedure.

• Most patients report symptom relief and are able to return to normal daily activities immediately, with little or no pain.

And finally Your legs will look great!

For more information about vein treatments, please visit: or contact the office at 904-461-0821.

The Center for Advance Vein Care (CAV care) treats all of the aspects of venous disease, the most common of which are varicose veins, spider veins, venous ulcers, and refluxing veins. We utilize the VNUS® Closure® procedure and treatments usually last approximately 45 minutes. In order to provide for total comprehensive vein care, vein stripping, ambulatory phlebectomy and sclerotherapy are also performed at the Center for Advance Vein Care.

Dr. Ryan J. Pereira (pictured above) has been in practice since 2002 and has been treating venous disease since 2005. He is a Diplomat of the American Board of Podiatric Surgery and is Board Certified in both Foot Surgery and Reconstructive Rearfoot/Ankle surgery. He is also a Fellow of the American College of Foot and Ankle Surgeons. He graduated from the Ohio College of Podiatric Medicine with his Doctorate in Podiatric Medicine.

Dr. David S. Ross (pictured below) has been in practice since 1977 and has been treating venous disease since 2008. He is Board Certified in both Emergency Medicine and Family Practice and is a Fellow of the American College of Emergency Physicians. He graduated with a Doctorate in Medicine from the University of Florida.


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