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What To Expect



On your first visit to Hager Advanced Vein Care we recommend that you wear or bring along a pair of shorts so we are able to evaluate your leg veins. A complete patient history will be obtained as it is necessary for a thorough evaluation. You will meet our office staff and physician to review your medical issues and create a plan of care.

Most patients with varicose veins will require a venous ultrasound of their leg(s). This ultrasound provides a roadmap of your veins. This roadmap is paramount in determining the optimal treatment of your veins. This study is non-invasive. and is performed in the standing position by placing a painless transonic gel on your skin, and then a probe is placed on your leg. This probe can look through your skin to find the reason you have your varicose veins and will guide us in determining which technology will be best for you.

Once your ultrasound is complete you will be re-evaluated by our surgeon. He will review the results of your ultrasound and then discuss which procedure will be best for you. The risks, benefits, and treatment options of the planned procedure will be addressed in detail. Our doctor and staff understand that patients have many questions regarding their condition and treatment. We are happy to spend the time necessary so you can feel comfortable with your treatment options. We encourage you to contact us for more information or if you have any questions at anytime during the course of your evaluation and treatment.



On the day of your procedure, your leg will be prepped with a Hibiclens solution (to cleanse the skin of bacteria). Next, your doctor will use ultrasound to locate the incompetent (leaking) vein and to confirm the position of the catheter. He will then inject a small amount of lidocaine just around your knee over the area of the diseased vein to numb the area so you will not feel him insert the catheter.

Next, a special solution called tumescence, that has numbing medication mixed in it will be injected along the course of the vein. There will be some discomfort that most people describe as stinging. This only takes a few minutes. At the end of the procedure, you will be put in a compression stocking to provide support. You should be ready to go home within 20 – 30 minutes after the procedure. You will need to return to the office in three to four days for an ultrasound examination of the treated vein.

Sometimes, patients may need additional procedures to achieve optimal results. Other treatments may include phlebectomy (removal of branches of the vein through very tiny incisions) and/or sclerotherapy (lnjection of a sclerosing medication directly into the veins to close them off). We will usually wait until after the ablation procedure to see how much improvement occurs before scheduling any additional procedures since many patients do not require any additional treatment.



Endovenous ablation vein treatments have been performed in the United States for over 15 years in thousands of patients with excellent success. Multiple clinical trials have demonstrated the safety and effectiveness of this procedure in the short term and long term. This procedure has been shown to be more effective than vein stripping with significantly less discomfort and less recovery. We have personally performed endovenous ablation or radiofrequency closure of varicose veins in hundreds of patients with greater than 95% success and no major complications over the last 12 years.

Some patients do experience bruising and discomfort (described as aching, burning or pulling) along the treated vein segment in the thigh. This typically resolves within 1 to 3 weeks without long-term problems.

Superficial phlebitis is uncommon but can cause inflammation and discomfort for several weeks and is treated with over-the-counter medications. Skin burns are extremely rare and have not been seen in our practice. Blood clots are possible but fortunately occur less than 1 % of the time. When clots do occur, they are treated with a blood thinner called Lovenox, usually for several weeks.


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