Our treatment protocol is based on a variety of anatomical and physiological models. Our
belief is that vein therapy should give long lasting solutions to circulation disorders.
Below is our protocol in detail. Please refer to the published and copyrighted Parisi
Pathway for Limb Preservation for full details.
First Step: Deep Vein Ultrasound and Arterial-Brachial Index with Segmental
The Deep Vein Ultrasound (DVU) is an initial evaluation of your lower extremities using
noninvasive ultrasound. This is to determine if you have venous reflux disease (“reflux”).
Reflux is when the vein or its valves do not work properly. When that occurs, blood pool
sin the lower part of the legs and does not return to the heart as well. Las Vegas Vein
believes that vein therapy may assist those with edema that is form a non-circulation
condition as long as there is reflux disease in the lower extremities. An arterial-brachial
index (ABI) is an ultrasound to evaluate the blood flow from the top of the legs to the
lower aspect. Some wounds are from arterial disease however others are from venous
reflux. This initial evaluation helps direct your care. For example, a patient that has
under gone ABI and hyperbaric medicine came to the clinic for wound care however,
found to have significant reflux disease. Has treatment for both legs as well as TCOM
measurements, graft placement, more hyperbaric, proper orthotics, returned to exercising
and helping himself.
Second Step: Transcutaneous Oxygen and Measurements (TCOM)
TCOM measurements are used to determine if a wound is able to heal with the present
condition of the limb. A non-invasive test, the TCOM has small probes attached to the
skin on the surface around the wound and in other predetermined areas. If the values are
within normal range then proper wound management will begin. If there is compromise
in the circulation, then Hyperbaric will begin. Hyperbaric Medicine is performed at
wound care centers that have been certified by all national wound care agencies.
Third Step: Venefit Procedure
What? It means that the vein is closed within your body using a ultrasound probe with
no surgical stripping, sutures, or scarring. Vein therapy has shown to be a necessary
part of wound care as well as limb salvage. The entire procedure is performed through a
single intravenous (IV) sight. The basic premise of the procedure is that the ultrasound
probe emits heat pulse. This heat pulse melts the protein lining the vein. As the catheter
is withdrawn, the vein is compressed and the protein acts like glue holding it shut. The
leg is wrapped in a compression bandage to brace the vein together as the protein cools
and remains closed. This technology is safe to use on patient that have experienced
amputations, chronic wounds, acute wounds due to trauma, and other circulation
disorders such as: atherosclerosis and some hematological disorders in which there are
Fourth Step: Phlebectomy
Phlebectomy is the removal of medium sized veins from the skin surface period. This
entails small incisions in the superficial skin layer and the removal of the vein using
small, various specific instruments. The visible vein is tied at each end, excised, and
removed. The incisions are not stitched and therefore scarring is minimal if visible at all.
Fifth Step: The Sclerotherapy
Sclerotherapy is a treatment of small, visible veins using a solution that causes the vein
to remain closed and then disappear. The solution itself is painless when introduced to
the vein. After EVCA treatment, the veins present on the surface will remain on the skin
because of the way the veins grew into the tissue. These veins will need to be removed
to complete treatment, as the veins can become thrombosed, or clotted (phlebitis). They
also become inflamed and painful. Once these vessels are removed, they will more
than likely to never return. It is based on the anatomical aspect of the Las Vegas Vein
Protocol. If the smaller, surface veins are connected to a larger vein that has recently
been closed, then where do they get their blood supply? Those veins do not have a
blood and will simply remain in the skin. In the skin, those veins can do nothing other
than clot or become inflamed. The use of sclerotherapy and YAG laser therapy has
shown to be effective treatments for these small surface veins.
Sixth Step: Nd: YAG (Neodymium-doped yttrium aluminum garnet) Laser
Nd: YAG Laser Treatment (YLT) is a proven treatment for superficial veins, the
treatments emit a laser pulse, which causes the veins to remain closed, and they
disappear, much like sclerotherapy. The difference in the treatments is the YLT can
remove veins in a non-invasive manner and can also treat much smaller veins that
would be very difficult to access with sclerotherapy.