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Posts Tags as "vnus closure"
What is venous insufficiency ?
Friday, November 9, 2012

Superficial venous reflux can also cause symptoms in patients who have no obvious varicose veins. This means that there are patients who have all of the symptoms listed bloew without obvious varicose veins who may have this condition. They come in for evaluation because they have:

 

  • aching and pain in the legs
  • heaviness of the legs
  • tired legs
  • leg fatigue at the end of a work day
  • itching of the legs
  • cramping of the legs
  • throbbing of the legs
  • restless legs
  • swelling of the legs

 

Other patients have both signs of venous disease (spider veins, reticular veins and varicose veins) and symptoms suggesting venous refux disease.

 

If you suffer any of these symptoms, you should be evaluated by a vein specialist. Hratch Karamanoukian, MD FACS is a Board Certifed Vein Specialist with offices in Williamsville, NY, Clarence, NY and East Amherst, NY. Call 716-839-3638 to schedule a consultation.  

In Southern California, contact Dr. Raffy Karamanoukian of the Santa Monica Vein Center at www.SantaMonicaVeinCenter.com or call 1-310-998-5535

 

How is venous reflux related to vein valves ? The Venefit Procedure and EVLT
Sunday, November 25, 2012

 

If the one-way vein valves malfunction, blood can leak back into a lower level and collect there. This problem is called venous insufficiency. Pooled blood enlarges the vein and over time, it becomes varicose. Mechanically minded people refer to ‘one-way’ valves as ‘check valves’.

 

In essence, vein valves are healthy when they function as one-way valves and they are considered diseased when they function like two-way valves. ‘Two-way’ valves act like ‘saloon doors’ in Western movies.

 

Venous reflux disease pushes blood from the deep veins into the superficial veins. This is called superficial venous reflux disease. Its gets more complicated as there is superficial venous reflux disease, deep venous reflux disease and perforator venous reflux disease. Deep venous reflux is leakage of valves in the deep veins. Perforator venous reflux is leakage of blood from the deep veins into the superficial veins through these perforator (or connecting) veins.

 

**The VNUS Closure Procedure is now called the Venefit Procedure. Same procedure, different name.

 

Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or www.VeinsVeinsVeins.com 

 

Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or www.SantaMonicaVeinCenter.com 

 

Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.

How do compression stockings work ? What is the role of the Venefit Procedure (previously called VNUS Cllosure) ?
Sunday, November 25, 2012

 

Compression stockings or compression therapy are often a first line of defense in treating venous conditions. They are commonly required by insurers prior to approval for vein procedures, including VNUS Closure® (new name Venefit Procedure) or EVLT®. Although compression stockings may alleviate  symptoms of venous disease, they do not get rid of varicose veins or directly treat venous reflux disease.

 

Gradient compression delivers a squeezing to the leg.  The degree of compression is highest at the ankle (most squeeze) and gradually decreases as one goes up to the thigh and waist. This compression, is generally expressed in mmHg (millimeters of mercury).

 

Compression is believed to increase the pressure in the tissues beneath the skin thus reducing excess leakage of fluid from the capillaries and increasing absorption of tissue fluid by the capillaries and lymphatic vessels. Compression stockings therefore reduce swelling and also prevent leg swelling.

 

Medical grade compression also limits the size (diameter) of superficial veins beneath the skin.  The stocking does not allow these superficial veins to engorge with blood. This action helps prevent "pooling" of venous blood in the superficial veins. The venous blood is able to circulate more efficiently in the lower extremities.

 

**The VNUS Closure Procedure is now called the Venefit Procedure. Same procedure, different name.

 

Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or www.VeinsVeinsVeins.com 

 

Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or www.SantaMonicaVeinCenter.com 

 

Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.

 

 

Spider Vein Removal Buffalo - Board Certified Vein Specialists Buffalo - Board Certified Phlebologist Buffalo
Sunday, December 2, 2012

 

 

We have the most advanced treatments available to treat venous insufficiency:

 

Venefit Procedure (previously called VNUS Closure)

 

EVLT Never Touch for the saphenous veins

 

EVLT Never Touch for Perforator vein reflux

 

ClariVein Procedure

 

As Board Certified vein specialists (Phlebologist), we also perform all types of vein procedures:

 

Traditional sclerotherapy

Foam sclerotheapy

Ultrasound guided foam sclerotherapy

Topical Laser treatments for spider veins

Microphlebectomy

 

 

Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or www.VeinsVeinsVeins.com 

 

 

Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or www.SantaMonicaVeinCenter.com 

 

Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.

Miami Vein Center study with the 1470 nm Laser by Jose Almeida and collegaues
Monday, December 3, 2012

 

 

"The 2 primary objectives of this study were to investigate whether the 1470-nm wavelength laser (EVLT, EVLA) can close a saphenous vein painlessly and determine safety, efficacy, and side effects".

 

The study abstract is shown verbatim.

 

"The study was conducted by ALmeida and colleagues at the Miami Vein Center and the University of Miami. In all, 26 limbs were treated with a radially-emitting fiber at low energy ranging from 20 J/cm to 30 J/cm. Then 41 veins were treated with the 1470-nm laser at 30 J/cm at 5 watts, using standard perivenous tumescent anesthesia in Miami and compared to a historical control (980 nm, 80 J/cm, and 12 watts). We demonstrated that the 1470-nm wavelength endovenous laser system could not close saphenous veins without use of anesthesia".

 

"Closure with a dramatic reduction in energy when compared to a 980-nm wavelength control demonstrated a marked reduction in postoperative pain and ecchymosis; this implies that vein-wall perforations are minimized with this system".

 

Varicose Vein Treatment Buffalo, NY, Vein Specialist Buffalo, NY, Spider Vein Treatment, Buffalo, NY, Venefit Procedure, Buffalo, NY, EVLT Buffalo, NY, Clarivein Procedure, Buffalo, NY
Friday, December 7, 2012

 

There is nothing wrong with having a general surgeon or radiologist to do your vein procedures. However, a dedicated surgeon who is also a phlebologist (vein specialist) brings a whole element of specialty care to the practice of vein disorders.

 

At the Vein Treatment Center, the focus is not just one procedure for all patients, namely 'vein stripping', but rather a variety of procedures that are individualized and targeted to treat specific problems: varicose veins, truncal venous reflux disease, perforator venous reflux disease, vein related skin diseases, treatment of venous stasis ulcers, VNUS Closure, Venefit Procedure, EVLT, EVLA, ELVeS, EVLT Never Touch, foam sclerotherapy, Ultrasound guided sclerotherapy, topical lasers for spider and reticular veins, SEPS, etc.

 

For a detailed evaluation, call the Vein Treatment Center for a consulation with Dr. Hratch Karamanoukian. Dr. Hratch Karamanoukian is triple board certified - in general surgery (American Board of Surgery), Cardiovascular Surgery (American Board of Thoracic Surgery) and Venous Surgery (American Board of Phlebology). We don't dabble in vein care, but treat it as a medical/surgical specialty. Ask your 'vein doctor' if he is Board Certified in Phlebology!

 

716-839-3638

www.VeinsVeinsVeins.com

Offices in Clarence, NY and Williamsville, NY

 

VNUS versus EVLT versus Foam Sclerotherapy
Sunday, December 9, 2012

 

A study comparing various techniques to treat varicose veins was published by the Division of Vascular Surgery, University of Cologne, Cologne, Germany in the J Cardiovasc Surg (Torino). 2008 April; 49(2): pages 213-33. The researchers, T Luebke and J Brunkwall looked at the efficacy and safety features of VNUS Closure (RO), EVLT and foam sclerotherapy (FS).

 

"RFO was associated with the worst short and long-term safety and efficacy results compared to EVLT and FS regarding ''complete occlusion at the end of follow-up'', ''phlebitis'', ''deep vein thrombosis'', and ''paraesthesia''. EVLT had the best results concerning the long-term effectiveness parameters for ''occlusion at the end of follow-up'' and ''recanalization, recurrence or development of new veins'', compared to RFO and FS. Foam sclerotherapy of varicose veins is associated with a higher recurrence rate in patients with saphenofemoral incompetence compared to the rates after EVLT or RFO treatment".

 

Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or www.VeinsVeinsVeins.com 

 

Dr. Hratch Karamanoukian welcomes patients from Ontario, Canada. Our offices are minutes away from the Peace Bridge and patients can be in and out of the office in less than 90 minutes and expect to return to work the same day in 99% of cases.  

 

Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or www.SantaMonicaVeinCenter.com 

 

Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.

 

Venefit Procedure Experts - Venefit Procedure News - Venefit Procedure FAQ and Information - Buffalo Vein Expert
Tuesday, January 1, 2013

Comprehensive Information about the Venefit Procedure (VNUS Closure) at your fingertips by Buffalo Vein Expert Hratch Karamanoukian MD FACS, a Board Certified Phlebologist (Vein Specialist) - VeinGuide.com and VeinsVeinsVeins.com

 

Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 orwww.VeinsVeinsVeins.com 

 

 

Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 orwww.SantaMonicaVeinCenter.com 

 

Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.

 

 

VNUS Closure procedure at the Vein Treatment Center in Buffalo Niagara, minutes away from the Peace Bridge - Canadian patients welcome
Monday, September 2, 2013

 

 

There are many reasons to undergo treatment for venous insufficiency.  During your consultation for varicose vein problems, Dr. Karamanoukian will evaluate your legs with visual inspection, vein mapping with Vein Lite which transilluminates the veins AND use the Vein Viewer which uses infrared technology to visualize the veins - as such, Dr. Karamanoukian will map the varicose veins, reticular veins, feeder veins and spider veins in the legs. 

 

Next. Duplex scanning is peformed to determine whether there is venous insufficiency at the saphenofemoral and saphenopopliteal junctions, aslo known as truncal venous insufficiency. This determines whether you are a candidate for endovenous laser (VenaCure EVLT), Radiofrequency ablation with the Venefit Procedure (previously called VNUS Closure), or the ClariVein Procedure (mechanochemical ablation). 

 

 

We next determine which pattern of great saphenous vein (GSV) or small saphenous vein (SSV) reflux exists for classification and treatment:

 

  1. Segmental reflux - reflux source or origin from a tributary or perforating vein distal to the saphenous junction and reflux drainage through a tributary or perforating vein in the thigh, knee or calf.
  2. Distal reflux - reflux source or origin from a tributary or perforating vein distal to the saphenous junction and drainage through veins at the ankle.
  3. Proximal reflux - reflux source at the saphenous junction and drainage thorugh tributary or perforating vein at the thigh or calf, but proximal to the ankle.
  4. Multisegmental reflux - Two or more reflux segments with five basic types - proximal segmental, proxmal distal, segemental segmental, segmental distal and proximal segmental distal.
  5. Diffuse reflux - reflux source at the saphenous junction and drainage at the ankle and no discernable patern or from of the great sapehnous vein.
  6. Perijunction reflux -
  7. Normal pattern - absence of extension into the saphenous vein down to the ankle

 

This pattern utilized is from CA Engelhorn from Phlebology 2012; 27: 25-32.  

 

 

 

 

 

At the Vein Treatment Center, Dr. Karamanoukian also utilizes the newest and most advanced laser system to perform endovenous ablation procedures ! This happens to be the VenaCure endovenous laser therapy (EVLT) Never Touch system. Dr. Karamanoukian has been using the VenaCure EVLT Never Touch system since 2007 and to date has performed over 18,000 endovenous ablation procedures - combined Venefit Procedure (previously called VNUS CLosure, EVLT and EVLT Never Touch Procedures). We incorporated the VenaCure Never Touch procedure in our armamentarium of procedures since 2009 to treat venous insufficiency involving the great saphenous (GSV) and small saphenous (SSV) veins.

 

Although other surgeons were quick to adopt this second generation FAST catheter, Dr. Karamanoukian waited for the clinical results to be published in the scientific literature before adopting it and using it in his patients. Having published over 140 scientific articles, Dr. Karamanoukian believes that adopting new technology should await hard proven scientific data. However, Dr. karamanoukian is the first surgeon in the world to perform bilateral VNUS Closure procedures (Venefit Procedure) at the same office setting! This is very helpful in reducing the number of trips and allowing the patient to resume all activities as soon as possible, typically returning to work the same afternoon and certainly by next morning ! This work was started in 2006 and presented with 2 year follow-up at the 2009 American College of Phlebology Meeting in Palm Desert, California.

 

The benefit of having your treatment done at the Vein Treatment Center is that we have both EVLT laser and VNUS Closure FAST (Venefit Procedure) technology and Dr. Karamanoukian will determine which technology best suits the anatomy and pathophysiology of venous insufficiency in a particular patient. We are the only center in Western New York to have both of these technologies under one roof and with a large expertise in performing both of these procedures by our Board Certified Phlebologist, Dr Karamanoukian.  We have also been using a third technique, namely mechanochemical ablation with ClariVein technology. No other center in the U.S. or Canada utilizes all 3 different methods in treating venous insufficiency:

 

  1. Venefit Procedure - uses radiofrequency energy to obliterate saphenous veins or perforator veins
  2. VenaCure EVLT Never Touch - uses laser energy to obliterate saphenous veins or perforator veins
  3. ClariVein - uses mechanical and foam sclerotherapy to obliterate saphenous veins

 

The benefits of the VNUS or Venefit endovenous ablation system are as follows:


  1. Minimally-invasive procedure for varicose veins: Avoids prolonged surgery or extended downtime.
  2. Quick recovery when compared to traditional vein stripping procedures.
  3. Less pain and discomfort when compared with vein stripping procedures.
  4. Excellent clinical outcomes: see study below ... '5 year outcome study of Venefit Procedure" :

 

 

Covidien on December 20th, 2012 reported durability of the Venefit Procedure (previously called VNUS Closure) in a 5-year outcome study.

 

 

 

The ClosureFast Study was conducted at eight centers in Europe from April 2006 to June 2007. The Venefit procedure, using the ClosureFast radio frequency ablation catheter, was used to treat 295 lower limbs in 225 patients diagnosed with superficial venous reflux, the underlying cause of varicose veins and [chronic venous insufficiecy].

 

 

 

Dr. Proebstle of Germany reported that "full occlusion of the treated vein was observed in 92 percent of patients versus 98 percent at one year. Also, 95 percent of the patients were free of pathological venous reflux as against 99 percent at one year".

 

 

 

Dr. Karamanoukian of the Vein Treatment Center performs the VNUS Closure Procedure - now called Venefit Procedure (new name).

 

 

 

Dr. Hratch Karamanoukian contributed 7 chapters to the American College of Phlebology Patient Education Book titled 'Healthy Veins .... Healthy Legs' - A Patient's Guide to Phlebology'. The book was edited by Raffy Karamanoukian MD FACS and Helane Fronek MD FACP FACPh.

 

 

 poster

 

 

 

 

 

 

 

 

The book can be ordered from the American College of Phlebology website.  The American College of Phlebology is the premier organization for vein specialists in the United States. Dr. Karamanoukian is a member of the American College of Phlebology and is a Diplomate of the American Board of Phlebology.

 

 

Most of the procedures we do for venous insufficiency require 1 or 2 needle sticks and the rest of the procedures, such as vein stripping and ligation procedures, are relegated to the history books (for the most part) and are performed today by general surgeons.

 

 

 

The procedures we do today that follow EVLT laser or VNUS Closure use non surgical techniques with no cuts, no sutures and return to work IMMEDIATELY !  There is no down time.

 

 

 

That's right, you can have great legs at any age if you take preventive measures and walk every day, wear compression stockings, exercise your leg muscles to keep the 'calf muscle pump' strong and take some natural supplements which have been shown to help prevent venous insufficiency (read Dr. Karamanoukian's books about horse chestnut extract and bioflavonoids) - you can also visit my website www.MyVeinStore.com to read and purchase Veinamin supplements.

 

 

 

The main aim of the treatments offered by Dr. Karamanoukian is to provide the highest possible comfort with treatments that have efficacy and proven track record in the scientific literature. We have also strived to provide all of the above while maximizing the aesthetic results desired by patients with venous diseases. 

 



 

 

We have the spectrum of procedures that allow return to work 'smae day or following day' :

  

 

  1. ClariVein procedure - one needle stick procedure for venous reflux
  2. VenaCure EVLT Never Touch
  3. VNUS Closure Fast, also known as Venefit Procedure
  4. VenaCure EVLT peroforator vein Procedure
  5. Foam Sclerotherapy
  6. Topical laser treatments
  7. Ultrasound guided sclerotherapy
  8. Microphlebectomy

 

 These procedures assure a high level of safety with minimal incisions and scarring potential.

 

 Our patients return to work immediately after the procedures or the day after in more than 99% of cases. We do not encourage patients to take time off from work unless they lift heavy things (> 40 ounds) at work. The only activity we discourage is weight lifting at a gym for 48 hours after the procedure.

 

 

CPT Procedure codes for VNUS Closure FAST and CPT Procedure codes for EVLT - venous ablation procedure codes
Monday, September 2, 2013

 

 

Ablation of 1st vein with radiofrequency (VNUS Closure) - 36475

 

ABlation of 2nd vein with radiofrequency device (VNUS Closure) - 36476

 

Ablation of 1st vein with endovenous laser therapy (EVLT, EVLA, ELVeS) - 36478

 

Ablation of 2nd vein with endovenous laser therapy - 36479

 

For the treatment of venous insufficiency with EVLT, VNUS Closure or ClariVein, contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York or call 716-839-3638.

 

 

 

Hratch Karamanoukian, MD FACS is triple board certified in general surgery, thoracic surgery (cardiovascular surgery), and phlebology (diseases of the venous system and lymphatic system).

 

 

 

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