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Albert Vein Institute: Advances In Varicose Vein Care
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Advances In Varicose Vein Care

October 11, 2018

Advances In Varicose Vein Care

Current healthcare patients live in a unique time of unprecedented levels of medical advances that affect so many healthcare fields. Decreased invasiveness of procedures has paved the way for patients to experience less pain, shorter recovery time, lower infection rates, and so much more. Phlebology (the treatment of varicose veins) has dramatically improved in the last 25 years thanks to a variety of subspecialty advancements.

There has been a welcome advance away from the past days of hospital-based vein stripping with today’s minimally invasive vein care. During vein stripping, a surgeon uses a wire attached to the vein where it joins the deep veins and then pulls it near the middle of the calf.

Vein stripping also requires general anesthesia. Usually needed for more major surgeries, general anesthesia comes with risks and less invasive models should be used when available. Vein stripping and its required use of general anesthesia is now obsolete unless there is a particular medical reason a patient cannot be a candidate for minimally invasive vein care in an outpatient setting. Today’s techniques for treating varicose veins involve endovenous (inside the vein) ablation using laser or radiofrequency technology with no general anesthesia and only minimal medication is administered to provide comfort during the procedure.

Today’s minimally invasive treatments will usually only require the use of compression stockings under the supervision of your vein care physician and periodic follow-up appointments scheduled at your convenience.  Furthermore, minimally invasive endovenous procedures only require tiny incisions, whereas vein stripping requires larger incisions (closed up by stitches) that might leave behind scars.

Please note: Patients who are not satisfied with the results of previous vein stripping might still be a candidate for improvement with today’s minimally invasive endovenous techniques.

If you are considering having your varicose veins evaluated – make sure to research all providers before undergoing treatment, as all physicians have various medical and surgical backgrounds. There are even non-physicians performing minimally invasive vein care. At best, look for a board-certified physician or surgeon who practices in an accredited vein care facility.

Dr. James D. Albert, RPVI is the Founder and Practicing Physician of Albert Vein Institute (AVI)–Colorado’s Vein Specialist – founded in 2006. A nationally respected Phlebologist, Dr. Albert has led AVI to become Colorado’s ONLY nationally recognized IAC ACCREDITED VEIN CENTER. Dr. Albert trained at the nation’s most reputable medical institutions, holds double Board Certifications in Cardiovascular Surgery and Phlebology, and is humbled to bring 30 years of a successful surgical career to patients needing vein care.

Posted in Blog, Doctor's Quarterly, Featured by Jen Johnson
September 14, 2018
TopDocs

Top Docs 2018

The September/October 2018 issue of Colorado Springs Style magazine features its annual list of Top Docs, and Dr. Albert has been named among the region’s best for the 7th year in a row. Here is the complete list of Colorado Springs doctors who received the recognition.

Based on the premise that medical professionals are best qualified to judge other medical professionals, Colorado Springs Style and El Paso County Medical Society used a confidential peer-to-peer survey to ask local doctors who they would recommend for a friend or family member requiring medical care.

Since founding Albert Vein Institute in 2006, Dr. Albert continues to pave the way for the growing subspecialty of Phlebology in Colorado Springs and Denver. Albert Vein Institute remains Colorado’s First and Only IAC Accredited Vein Center and has formed affiliations with accredited Phlebology Organizations and venous programs across the country – aimed to combine the research and expertise of Albert Vein Institute’s medical program with other vein care leaders.

 

 

Dr. James D. Albert, RPVI is the Founder and Practicing Physician of Albert Vein Institute (AVI)–Colorado’s Vein Specialist – founded in 2006. A nationally respected Phlebologist, Dr. Albert has led AVI to become Colorado’s ONLY nationally recognized IAC ACCREDITED VEIN CENTER. Dr. Albert trained at the nation’s most reputable medical institutions, holds double Board Certifications in Cardiovascular Surgery and Phlebology, and is humbled to bring 30 years of a successful surgical career to patients needing vein care.

Posted in Blog, Featured by Jen Johnson
July 30, 2018

From Colorado’s Vein Expert: Answering common questions patients ask about veins

One common question asked at Albert Vein Institute (AVI) by our patients is “Don’t I need my saphenous vein?” The function of the saphenous vein is to protect the skin veins from the mildly increased pressure in the deep veins. Unfortunately family history, pregnancy, excessive standing, and advanced age cause the saphenous vein to deteriorate. The saphenous vein is like your appendix in the sense that if it is not functioning properly then you do not need it anymore.  Most varicose vein procedures involve endovenous ablation in order to gently destroy the saphenous vein.

 

98% of the blood returning to the heart from your legs does so through other leg veins in the deep system – so if the saphenous vein is not functioning properly, and left untreated, the venous circulation in the legs is less efficient and can lead to bigger problems. By not treating the diseased saphenous vein, you can develop uncomfortable symptoms like pain, swelling, skin changes, and non-healing wounds on your leg.

 

Patients also ask, “What happens if I need a vein for heart surgery down the road?” As AVI’s practicing physician, as well as a double Board Certified Cardiovascular Surgeon and Phlebologist who practiced heart surgery for more than 20 years, I would never destroy a vein that could functionally be used for coronary bypass surgery. If you are having your saphenous vein treated to resolve your varicose vein problems, then this same vein would be too diseased to use for heart surgery anyway. I frequently identify that the saphenous vein in patients with superficial venous insufficiency is not usable for coronary bypass.  Furthermore, there are other vessels that can be used if the saphenous vein is diseased or has previously been treated.

 

In fact, patients who have had their saphenous vein harvested for coronary bypass surgery can still have problems with varicose veins. This difficulty can occur because only part of the saphenous vein was removed for heart surgery, while the remaining part of the vessel goes on to become diseased.

Author: Dr. James D. Albert, RPVI

Posted in Blog, Doctor's Quarterly, Featured by Jen Johnson
July 30, 2018

From Colorado’s Vein Expert: Debunking Falsehoods of Vein Disease

Varicose Veins are Only a Cosmetic Issue

Many people, even physicians, believe that varicose veins are only a cosmetic issue and don’t need to be addressed medically.  However, if you have symptomatic varicose veins (pain, heaviness, swelling, itching, restlessness) there is a deeper medical problem.  If left untreated, more serious health problems can arise like permanent skin changes, ulcerations, and increased risk of a deep venous thrombosis (DVT).

My Insurance Won’t Pay for My Varicose Veins

If you have symptomatic varicose veins as listed above, then many insurance carriers will cover the treatment of your varicose veins.  Most insurance carriers do have a set of requirements that patients must meet before a procedure can be performed.

**Each insurance carrier and plan are different, so verification of benefits is recommended.

Compression Stockings Will Treat My Varicose Veins

Medical compression stockings have long been a main stay in the treatment of varicose veins, however they do not actually treat them.  Compression stockings will provide relief to the symptoms that are caused by varicose veins, but they will not make the veins themselves go away or the symptoms.  To treat varicose veins, the source of the problem must be corrected by closing the saphenous veins.  To determine if your saphenous veins are working properly, a non-invasive ultrasound is performed and read by a qualified physician to finalize your treatment plan.

I’ve Had a DVT (Blood Clot) and I Can’t Treat My Varicose Veins

Many patients with varicose veins have had DVTs in the past and are able to be successfully treated today for their varicose veins.  An initial ultrasound will be performed and further testing may be ordered to give a clear picture of your leg before proceeding with treatment.   Also, patients can be treated while on blood thinners for maximum safety.

I Will Have to Miss Weeks of Work to Have My Varicose Veins Treated

Unlike vein stripping of the past which could cause extended absences, many patients today only miss 1-2 days of work after their vein procedures.  In fact, most patients go back to work the very next day.  Patients are even encouraged to maintain most work out routines during treatment.

Posted in Blog, Doctor's Quarterly, Featured by Jen Johnson
July 30, 2018

From Colorado’s Vein Expert: You Have A Personal Choice When It Comes to Treating Varicose and Spider Veins

In today’s environment of aggressive Internet marketing, patients are frequently presented with conflicting information about the health risks of varicose veins (VV) and spider veins (SV).  It is important for patients to understand that VV are not “silent killers.”

“Free vein screenings” might be a marketing gimmick to get patients in the door, but without symptoms there is rarely anything an evaluation would discover that would require intervention. Even worse is the use of inaccurate threats stating “patients who do not get evaluated for VV are at risk for developing DVT and ulcers.”  Patients should only seek care for varicose or spider veins if they are experiencing aching, burning, itching, heavy legs or ankle swelling.

Older patients may naturally have superficial venous valve leakage (reflux), but it is often clinically insignificant. Patients should only be treated if they have significant symptoms. Patients should never be coerced to think that without treatment they will experience serious negative health outcomes.

If one thinks they have vein disease, choosing where to go is important. The differences between provider skill-set and facility qualifications could lead to vastly different long-term outcomes. Typically, physicians who practice Phlebology come from different backgrounds. So how does a patient decide where to have their veins evaluated?

Choose a physician who is dedicated to treating venous disease.  Physicians who practice Phlebology only part-time may have conflicting responsibilities, often resulting in scheduling disruptions and inability to thoroughly address patient concerns.

Choose a Physician that has micro-surgical experience. Choosing a physician with micro-surgical vascular experience is imperative, as removal of VV through micro-incisions is an integral part of complete venous care.

Choose an Accredited Facility. Most importantly, facility accreditation guarantees a practice provides maximum safety and proven treatments.  Vascular ultrasound laboratory accreditation (Vascular Testing) is frequently misrepresented as “facility” accreditation. While an IAC Accreditation in Vascular Testing is an important prerequisite, the highest accreditation a vein practice can achieve is the national IAC Accreditation in VEIN CENTER.

AUTHOR: James D Albert, M.D., RPVI of Albert Vein Institute

 

Posted in Blog, Doctor's Quarterly, Featured by Jen Johnson
June 15, 2018

Why are your veins blue? Your veins are blue because they are showing the color of deoxygenated blood. When your blood comes out of your aorta it is bright red versus when it comes out your vena cava (a large vein that carries deoxygenated blood from the lower body to the heart) which is a deep black blue. It all has to do with the binding of oxygen on hemoglobin (a porphyrin responsible for transporting oxygen in the blood) so if the oxygen binds to the hemoglobin then the blood is red but if there is no oxygen that binds on the hemoglobin then the blood is blue.

How much blood is pumped by your veins in day? The average adult has roughly 2,000 gallons of blood circulate through his or her VEINS and other blood vessels in a single day, which is enough to fill five hot tubs (Arkansas Heart Hospital).

How fast is blood pumped through your body? Traveling at roughly 3 feet per second, a blood cell in the average person travels through the ENTIRE body in about one minute. This incredible velocity moves about 83 gallons of blood an hour!

What is the longest vein in the body? Did you know that your Great Saphenous Vein is the longest vein in the human body? Extending from the top of your foot to the upper thigh and groin, THIS vein is the major culprit that causes Varicose Veins.

How long are your veins and the rest of your circulatory system? Did you know that if you laid out all of the blood vessels in the average adult (arteries, VEINS and capillaries), they would be long enough to stretch across the earth over 3 times?

Posted in Blog, Featured by Eric Olson
March 12, 2018

There are no Board Accredited Phlebology Fellowships in Colorado. The only “accredited” Phlebology Fellowship is at New York University in New York City. Any reference to a Phlebology Fellowship in Colorado is unrecognized and non-accredited by the American Board of Venous and Lymphatic Medicine. Any statement suggesting that completion of a non-accredited fellowship declares exclusive excellence (top percent of the nation, for instance) is false and misleading. In addition to understanding what the term “Phlebology Fellowship in Colorado” means when it comes to your vein specialist, it is also important make sure that claiming to be a Phlebologist is not the same qualifying credential as being a “Board Certified Phlebologist.” Only Physicians qualify to take the Board Exam given by the American Board of Venous and Lymphatic Medicine to become Board Certified in Phlebology. Anyone who just uses the term “Phlebologist” without the Board Certification claim, has not been “officially” Board Certified in Phlebology.

AMERICAN COLLEGE OF PHLEBOLOGY (ACP) is a membership organization for vein care-related physicians and allied health care members. It offers related educational courses on topics in the vein care industry. Any “certifications” that are associated with the ACP do NOT represent a Board Certification in Phlebology (vein care).

Dr. Albert has been a member of the ACP for twelve years and attends the annual National Conferences held in different locations across the United States. He has been an official Physician Presenter of medical information related to Phlebology at the ACP. Members of the AVI medical staff have also participated in sharing medical knowledge with ACP members. Dr. Albert is also a member of the International Union of Phlebology (UIP), and attends the World Conference on Phlebology, which meets every few years at international venues.

To learn more about vein care in Colorado from the Albert Vein Institute, contact our Colorado Springs location or our Denver location today at 1-888-550-8346.

Posted in Blog, Featured by Jen Johnson
November 21, 2017

Valuable Opinion on Vein Glue: Newer Not Always Better

James D Albert, M.D., RPVI of Albert Vein Institute

Having practiced Cardiac Surgery for over 25 years, I saw many FDA-approved heart valves promoted by industry as “revolutionary” advances in patient care that subsequently were recalled or failed expectation, resulting in re-operation or devastating patient outcomes.

You may have seen physicians claiming they are the “first” or the “only” provider in a State using “vein glue” adhesive. The product is not difficult to use and requires no specific technical expertise. The inference is that somehow these providers who make these claims are superior to those physicians who choose not to use the technology. Let’s objectively look at what we know and claims made about this product.

  1. RETAINED FOREIGN BODY

The company that promotes the product of “vein glue” has recently categorized it as an “implant.” In medicine, an implant refers to something like a heart valve or an artificial knee and can carry risk of infection.

“Vein Glue” is essentially the same product used to glue hip and knee replacements into patients’ bones. Therefore, we can assume it is never absorbed by the body and is a lifelong foreign body that stays in the vein. Results of vein closure at one year are promising but there are concerns about a foreign body that may never absorb and prevent the vein from absorbing. Infection may only be cured with full surgical excision of the glue infused vein. With standard laser and radio frequency ablation procedures, the treated vein usually disappears within one year. In these standard treatments, rare infections are almost always cured with antibiotics and NO surgery.

  1. LOCAL ANESTHESIA IS AVOIDABLE—WRONG!

The “straw man” argument is that the local anesthesia, which takes approximately 2 minutes to administer and is well tolerated by the vast majority of patients, would not be required with the use of vein glue. Most qualified vein care physicians perform not only ablation to treat the cause of the problem (saphenous vein) but perform the important micro-incision phlebectomy simultaneously to remove the result of the problem (varicose vein). Since local anesthesia is required for microphlebectomy, it is disingenuous to claim that local anesthesia is totally avoidable. If microsurgery is not performed in coordination with vein glue procedures, it is likely the big veins will not go away and they might clot.

  1. NOT USING LOCAL ANESTHESIA MEANS LESS PAIN—WRONG!

In the comparative studies of Vein Glue vs. Radio frequency or Laser Ablations, there were NO DIFFERENCES in the perceived pain levels whether local anesthesia was used or not. One can only conclude that patients feel pain when the glue comes in contact with the inside of the vein.

  1. INSURANCE COVERAGE IS NOT BEING PAID

At this time, there are recent insurance billing codes but no one is paying them. Patients who opt for this new technology will incur significantly more personal financial responsibility to receive this procedure.

  1. THERE ARE NO POTENTIAL RISKS OF VEIN GLUE—WRONG!

The list below is a published list of potential risks and complications that may occur with “vein glue” per the manufacturer. Although the incidence of these issues is low, this list is similar to those listed for Laser or Radio frequency Ablations.

POTENTIAL RISKS OF VEIN GLUE 

The {vein glue} procedure is minimally invasive and catheter-based. As such, it may involve the following risks. Your doctor can help you understand these risks:

ALLERGIC REACTION TO THE {vein glue}L ADHESIVE

ARTERIOVENOUS FISTULA (i.e., an abnormal connection between an artery and a vein)

BLEEDING FROM THE ACCESS SITE

DEEP VEIN THROMBOSIS (i.e., blood clot in the deep vein system)

EDEMA (i.e., swelling) in the treated leg

HEMATOMA (i.e., the collection of blood outside of a vessel)

HYPERPIGMENTATION (i.e., darkening of the skin)

INFECTION AT THE ACCESS SITE

NEUROLOGICAL DEFICITS INCLUDING STROKE AND DEATH

NON-SPECIFIC MILD INFLAMMATION OF THE CUTANEOUS AND SUBCUTANEOUS TISSUE

PAIN

PARESTHESIA (i.e., a feeling of tingling, prickling, numbness or burning)

PHLEBITIS (i.e., inflammation of a vein)

PULMONARY EMBOLISM (i.e., blockage of an artery in the lungs)

URTICARIA (i.e., hives) or ulceration may occur at the site of injection

VASCULAR RUPTURE AND PERFORATION

VISIBLE SCARING

CONCLUSION

The 1.5-year follow-up on the 100’s of patients who have received vein glue is dwarfed by the 10-15 year follow-up on millions of patients who have received either laser or radio frequency ablations. The potential benefit of being able to do both legs in a single day as local anesthesia is avoided is inviting but again would only be applicable for patients that did not require microphlebectomy (very rare).  Microphlebectomy is important for complete vein care.

The risks appear similar and the potential long-term side effects and efficacy of vein glue have yet to be determined. Additionally, the fact that it is not covered by insurance at this time places significant financial burden on patients and patients get no deductible credit. Even if a deductible is large, patients want to get credit against their deductible for other medical procedures that may be required in the same calendar year.

It is our opinion at Albert Vein Institute (AVI) that these potential unknowns and potential financial burden make the use of this product at this time only appropriate for the following types of patients:

– Patients with actual documented local anesthesia (lidocaine) allergy which is extremely rare.

– Patients who do not need simultaneous microphlebectomy (rare) who want to do both legs in the same day and have no concerns about procedure cost.

Dr. James D. Albert, RPVI is the Founder and Practicing Physician of Albert Vein Institute (AVI)–Colorado’s Vein Specialist – founded in 2006. A nationally respected Phlebologist, Dr. Albert has led AVI to become Colorado’s ONLY nationally recognized IAC ACCREDITED VEIN CENTER. Dr. Albert trained at the nation’s most reputable medical institutions, holds double Board Certifications in Cardiovascular Surgery and Phlebology, and is humbled to bring 30 years of a successful surgical career to patients needing vein care.

Posted in Blog, Featured by Jen Johnson
October 31, 2017

From Colorado’s Vein Expert: You Have A Personal Choice When It Comes to Treating Varicose and Spider Veins

James D Albert, M.D., RPVI of Albert Vein Institute

In today’s environment of aggressive Internet marketing, patients are frequently presented with conflicting information about the health risks of varicose (VV) and spider veins (SV).  It is important for patients to understand that VV are not “silent killers.”

Varicose and Spider Veins

Dr. James D. Albert, RPVI

“Free vein screenings” might be a marketing gimmick to get patients in the door, but without symptoms there is rarely anything an evaluation would discover that would require intervention. Even worse is the use of inaccurate threats stating “patients who do not get evaluated for VV are at risk for developing DVT and ulcers.”  Patients should only seek care for varicose or spider veins if they are experiencing aching, burning, itching, heavy legs or ankle swelling.

Older patients may naturally have superficial venous valve leakage (reflux), but it is often clinically insignificant. Patients should only be treated if they have significant symptoms. Patients should never be coerced to think that without treatment they will experience serious negative health outcomes.

If one thinks they have vein disease, choosing where to go is important. The differences between provider skill-set and facility qualifications could lead to vastly different long-term outcomes. Typically, physicians who practice Phlebology come from different backgrounds. So how does a patient decide where to have their veins evaluated?

Choose a physician who is dedicated to treating venous disease.  Physicians who practice Phlebology only part-time may have conflicting responsibilities, often resulting in scheduling disruptions and inability to thoroughly address patient concerns.

Choose a Physician that has micro-surgical experience. Choosing a physician with micro-surgical vascular experience is imperative, as removal of VV through micro-incisions is an integral part of complete venous care.

Choose an Accredited Vein Center. Most importantly, facility accreditation guarantees a practice provides maximum safety and proven treatments.  Vascular ultrasound laboratory accreditation (Vascular Testing) is frequently misrepresented as “facility” accreditation. While an IAC Accreditation in Vascular Testing is an important prerequisite, the highest accreditation a vein practice can achieve is the national IAC Accreditation in VEIN CENTER.

Do you have symptoms in your legs of aching, burning, itching, or swellings? If so, seek evaluation at a reputable and accredited facility to determine if venous insufficiency is the blame.

Dr. James D. Albert, RPVI is the Founder and Practicing Physician of Albert Vein Institute (AVI)–Colorado’s Vein Specialist – founded in 2006. A nationally respected Phlebologist, Dr. Albert has led AVI to become Colorado’s ONLY nationally recognized IAC ACCREDITED VEIN CENTER. Dr. Albert trained at the nation’s most reputable medical institutions, holds double Board Certifications in Cardiovascular Surgery and Phlebology, and is humbled to bring 30 years of a successful surgical career to patients needing vein care.

Posted in Blog, Featured by Jen Johnson
October 19, 2017

If you are searching for vein care, you can be certain that you will receive the highest level of competence and care when choosing a vein specialist that has been recognized as an IAC Accredited Vein Center. This “Vein Center” recognition is a consumer’s best friend when trying to decipher the variety of vein providers today. The achievement of Albert Vein Institute (AVI) as an IAC Accredited Vein Center is in addition to the certification that AVI has previously earned with our IAC Accreditation in Vascular Testing.

The IAC Accreditation in Vascular Testing means that AVI has the seal of approval from a reputable overseeing healthcare body for Ultrasound Interpretation and Testing. In order to receive the  “highest distinction” as an IAC Accredited Vein Center,  it is required for a vein clinic to also have the IAC Accreditation in Vascular Testing.  The Vascular Testing Accreditation is just one of many benchmarks of competence that an IAC Accredited Vein Center has achieved in its care and expertise.  Albert Vein Institute (AVI) is among an elite group of about 100 IAC Accredited Vein Center across the Country and the first and only one of its kind in Colorado which should be comforting for patients and referring physicians to know the difference.

Posted in Accreditation, Blog, Featured by Eric Olson