Schedule a Consultation
(716) 839-3638
Key points in the management of patients with varicose veins and superficial venous reflux disease - Vein Treatment Center and Dr. Karamanoukian
Wednesday, August 21, 2013




  1. It is important to adopt the classification system for patients with venous disease including the CEAP score and venous clinical severity score, VCSS.
  2. The quality of life indicators must be ascertained from the patient at the time of history taking to determine how venous disease affects the patient’s quality of life.
  3. Compression stockings alone may be appropriate for some patients with varicose veins and venous insufficiency.
  4. The addition of bioflavonoids (Varicosamin) or horse chestnut extract (Veinamin) to a regimen of compression stockings may also be helpful in eliminating symptoms of venous insufficiency in some patients –
  5. An adequate and complete medical and surgical history must be taken of past procedures including sclerotherapy and microphlebectomy and vein stripping (if any).
  6. Minimally invasive treatment options must be offered to the patient including endovenous laser therapy, VNUS closure, and the ClariVein procedures.  These are different options of treatment for venous insufficiency.
  7. A board certified phlebologist or vein specialist must determine or ascertain whether there is truncal venous insufficiency and or perforator venous insufficiency in the patient who presents with symptoms suggestive of venous insufficiency.
  8. A detailed examination by duplex ultrasound must be performed to look for superficial venous insufficiency, deep venous insufficiency, and perforator venous insufficiency.
  9. Patients with advanced trophic changes with CEAP scores of C3, C4, C5, and C6 must have expedited treatment options such as ablation procedures, microphlebectomy, ultrasound foam sclerotherapy to reduce the likelihood of developing primary or recurrent venous stasis ulcers.


For the evaluation and treatment of venous disorders contact Hratch Karamanoukian, MD FACS at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York or contact him through his website or or call 716-839-3638.


The Vein Treatment Center is a National Center of Excellence for Venous Disorders.  Dr. Karamanoukian is board certified in phlebology (venous diseases and diseases of the lymphatic system). or are partners with .



© 2012 Vein Guide, Inc. All rights reserved.