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How To Evaluate Vein Centers

Six things to look for in evaluating vein centers – Part 2

· Both Judi Kirkpatrick and Cynthia Washburn are having vein treatments as part of their Transitions medical make-over with Dr. Lori Greenwald. ·

Six things to look for in evaluating vein centers – Part 2

Not all vein centers are created equal. In my last blog post I told you three things to look for when evaluating vein centers. I was going to write about the other three today but the information on ultrasound competence took up a lot more space than I anticipated. So the last two things to look for will have to wait until next week.

Vein centers live and die on the basis of how good the ultrasound data is. Sure, physical examination is important, but a vein specialist (phlebologist) needs to know the exact anatomy of the veins to decide what to do. Ultrasound is the test that phlebologists use to see the anatomy. Imagine an orthopedist evaluating knee pain without a knee x-ray. It would be the same for a phlebologist to evaluate vein disease without an ultrasound.

Did you know that just because you have varicose veins it doesn’t mean that you need a procedure? Or that all patients who need a procedure don’t need the same procedure. How about that if a patient stands for a long time during an ultrasound, the technician can make the vein disease look worse. These are only a few of the subtle issues that a good ultrasound test of the legs can address. So, how can you be certain that you are getting an adequate evaluation? Look for the following:

  1. Does the ultrasound technician devote herself to vein disease or is she a jack of all trades? After all, you don’t want a carpenter telling you what’s wrong with your car. And you don’t want a technician that spends her time doing abdominal and gynecological ultrasounds looking at your leg veins. That technician doesn’t have the specialized knowledge that is required to know what, if anything, is wrong with your legs.
  2. Is the ultrasound lab accredited? Accreditation of the lab by ICAVL (Intersocietal Commission for the Accreditation of Vascular Laboratories) is a sign of excellence. Vein centers have to meet rigorous requirements to obtain accreditation. These include the number of studies performed and the number of false positives or false negatives that are found. You can find a list of accredited labs at this link:
  3. Is the technician an RVT (registered vascular technologist)? The RVT certification is a true symbol of excellence. To qualify for this prestigious certification a technologist must have performed many vascular examinations. He or she must pass a rigorous written examination, one that has a large failure rate. Only then can an ultrasound tech receive the RVT designation. You can find whether an ultrasound tech has the RVT designation at this link: Don’t be afraid to ask these tough questions when you are evaluating vein centers. If the office hesitates to answer them you should move on. Next week, I really will finish this article with the last two things to look for when evaluating vein centers

To read part one, click here!


Six things to look for in evaluating vein centers – Part 1

· Know the facts. Ask the right questions. ·

Six things to look for in evaluating vein centers – Part 1

Everyone tells you that they are the best. How can you evaluate all of these vein centers? I will give you a list of six things in two parts that you can use to evaluate these vein centers. Here is the first list of three things to look for.  I will list another three in next week’s blog post.

The biggest questions you need to answer and ask are:

  1. What technology do they use at the vein center? Varicose veins are treated by passing a catheter or plastic tube into the vein. This catheter is slowly withdrawn. As it is withdrawn heat is applied. This heat can be generated by a laser or by radiofrequency. These technologies are not the same. Laser therapy penetrates deeper into the surrounding tissue and causes much greater soft tissue damage. You can see a video demonstrating the difference in the September 11th blog post. Due to the greater tissue damage there is more pain after the procedure. Laser also causes more bruising and it takes longer for the leg to heal.
  2. Is it a full-time vein center? – A lot of so-called vein centers do not focus on treatment of vein disease. They may be run by a vascular surgeon who is very busy with his/her non-vein patients. Same thing applies to a radiology practice that does a small number of vein procedures. Phlebology (the study of vein diseases) is its own field with a great number of subtleties. New studies and information is always coming out. Only a full time phlebologist (vein specialist) can keep abreast of all these advances.
  3. Do they have a board certified phlebologist (vein specialist)? – You need to be able to differentiate among the various vein centers out there. One way to do this is to look for board certification. This certification is awarded by the American Board of Phlebology. In order to receive this prestigious designation the practitioner needs to show that they have performed a certain number of treatments and ultrasounds. They also have to pass a rigorous exam. You can feel more secure in the hands of a board certified phlebologist. You can find out if your physician is board certified at
  4. Well, that’s it for today. I will give you the next three tips on how to evaluate all these vein centers next week.