Vascular Surgery Associates P.A.
and its affiliate
Vein Institute of the Midwest
8901 W. 74TH ST., SUITE 257 • SHAWNEE MISSION, KS 66204
913-322-2211
veininstitutemidwest.com
Your Venous Laser Procedure has been scheduled.
Name:
Date:
Check-in time:
You should have received with these instructions, a consent form, and two prescriptions.
Please read your consent form thoroughly and bring it to the office unsigned the day of
your procedure.
Fill your prescriptions (both the sedative and pain medication) and bring them with you the
day of your procedure. You will be asked to take the sedative prior to your procedure once
you arrive in the office.
– Pre-Procedure Instructions –
1. You should have received a prescription for compression hose during your first office
visit (unless you are being treated for an ulcer). It is best if your compression hose are
thigh high or panty hose style. If your prescription is knee high or you did not receive a
prescription, please consult with us prior to your procedure. Do not wear your
compression hose on the leg we are performing the procedure on the day of your
procedure.
2. Shower and shave the operative leg as well as 1-2 inches in the pubic area on that side the
night before your procedure. Wear loose, comfortable clothing (such as sweat pants) to
your procedure.
3. Do not come to the office on an empty stomach. We encourage you to have a small meal
1-2 hours prior to arriving at the office. You may take all your medication as normally
scheduled.
4. Please arrange for someone to drive you home following the procedure. You will be
receiving local anesthetic and an oral sedative for your procedure and will not be able to
drive home. You will be in the office approximately 2-1/2 hours. The actual procedure
and will not be able to drive home. The actual procedure itself takes about 1-1/2 hours. If
your procedure includes ambulatory phlebectomy, you will be asked to spend the
remainder of the day with your leg elevated as much as possible.
Please note that although you will be receiving a sedative, you will still be awake during the
procedure. We encourage you to view the Venacure Laser Vein Treatment video on our website
at www.veininstitutemidwest.com.
– Post-Procedure Instructions –
1. You will have ace bandages in place when you leave the office and will be
expected to wear them for 24 hours. You may remove the ace bandages the day
after your procedure to shower and then replace them with your compression
hose. You will need to wear the compression hose day and night for seven days.
Then you will wear the compression hose during the day, especially during any
aerobic activity for at least one month. Please keep your leg elevated above the
level of your heart as much as possible the first 24 hours. Do not drive until the
day after your procedure.
2. You will have small 4x4 gauze dressings and steri-strips in place. You may
remove the 4x4 gauze at your first shower. Leave the steri-strips in place. No tub
baths until the steri-strips are removed and you are completely healed. They will
begin to come loose after 5-7 days, at which time you may remove them. If
possible, allow them to remain in place for two weeks.
3. Most patients experience some discomfort following the procedure. Some people
find it helpful to take one to two days off from work, although we expect you to
be able to resume all pre-procedure activities (including work) the following day,
if necessary. We will prescribe pain medication to be used as needed; many
patients are encouraged to take the pain medication the first 24 hours (you should
not drive if you are taking the pain medication). In addition, you may take an antiinflammatory such as Naprosyn (Aleve) 500mg twice daily, or Ibuprofen (Motrin)
800mg three times a day along with your pain medication. Please avoid Tylenol if
you are taking pain medication.
4. If you experience extreme bleeding or extreme discomfort notify the office
immediately. Bruising is normal. You also may feel a “pulling sensation” for the
first week following the procedure.
5. We would like you to continue to keep moving and maintain a normal level of
activity. Walking twice daily for 20 minutes is encouraged and promotes speedy
healing. Avoid heavy aerobic activity, weight lifting, or any water activities for
two weeks.
6. You will have a scheduled ultrasound the week following your procedure and a
follow-up office visit in one month. If you have an ulcer, your visit may be more
frequent.
Please note that although this procedure is being performed in the office, it is still
considered a minor procedure and will require some recovery. Please make arrangements
if you need someone to help in your care.
Please contact Mary, Melanie or Julie if you have questions or concerns.
Vascular Surgery Associates P.A.
Vein Institute of the Midwest
8901 W. 74TH ST., SUITE 257 • SHAWNEE MISSION, KS 66204
913-322-2211
veininstitutemidwest.com
Ambulatory Phlebectomy
Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like cords
and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose veins
are commonly found on the back of the calves or on the inside of the leg.
Q: What causes varicose veins?
A: The heart pumps blood filled with oxygen and nutrients to the whole body. Arteries carry blood from the
heart towards the body parts. Veins carry oxygen-poor blood from the body back to the heart. The
squeezing of leg muscles pumps blood back to the heart from the lower body. Veins have valves that act as
one-way flaps. These valves prevent the blood from flowing backwards as it moves up the legs. If the oneway valves become weak, blood can leak back into the vein and collect there. This problem is called
venous insufficiency. Pooled blood enlarges the vein and it becomes varicose.
Many factors increase a person’s chances of developing varicose veins:
· Increased age
· Family history
· Hormonal changes, such as puberty, pregnancy or birth control pills
· Obesity
· Leg injury
· Prolonged standing/sitting
What you should know about ambulatory phlebectomy:
There are several techniques for removing or reducing unwanted veins in your legs. These range from
injecting medications into the smallest veins (sclerotherapy) to endovenous laser ablation therapy for the
largest veins. Your doctor has recommended ambulatory phlebectomy, the most effective treatment for
medium sized varicose veins.
Ambulatory phlebectomy is an outpatient procedure in which numbing medication is injected into the skin
over the varicose vein. Then a small slit-like incision is made and segments of the varicose vein are
removed in one treatment. This will cause the entire varicose vein to disappear over a period of time.
Because the procedure is performed under local anesthetic, you will be able to drive home.
What to expect after the procedure:
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Your leg may be sore. Motrin or Extra Strength Tylenol will minimize the discomfort.
Although walking for 20 minutes daily is encouraged, when resting, elevate your leg above your heart.
Drainage may continue for the first 48 hours.
You may experience some swelling and bruising. Ice packs may assist in decreasing these symptoms.
You may remove your dressing and change the gauze (if needed) after 24 hours.
Wear your compression hose for the next 7 days and nights. Then wear the compression hose during
the day, especially during any aerobic activity for at least one month.
Please make a follow-up appointment in one month with Dr. Arnspiger.
Temporary bruising
Potential Side Effects or Complications:
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Swelling
Although every attempt is made to remove the entire varicose vein, there will be small segments that
remain in the skin. These fragments may become inflamed and irritated causing the condition
thrombophlebitis. The residual vein may feel like a hard core and may be tender. Over-the-counter
medications, compression stockings and time usually resolve the condition.
Rarely, a sensory nerve may be injured and skin numbness usually affects a small area only.
Movement or leg function should be affected.
I am aware that in addition to the risks listed above, there are other risks that may accompany any surgical
procedure, such as loss of blood, infection, and inflammation in the venous system with formation of a
thrombus (clot), post-operative bleeding, and nerve trauma that may lead to temporary or permanent
numbness.
By signing below, I acknowledge that I have read the foregoing information and understand the risks and
possible side effects, and alternative methods of treatment, and hereby consent to the treatment.
Patient Signature:
Date:
Physician’s Signature:
Date:
Physician: Richard C. Arnspiger II, M.D., F.A.C.S.
Witness Signature:
Date: