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Starling Vascular Vein


Venous disease of the lower extremities affects over 30 million people, most of whom suffer indefinitely. Leg discomfort, swelling, and varicose veins may be signs of significant vascular disease. Symptoms may worsen if left untreated.

Fortunately, there are now minimally invasive methods to treat symptomatic superficial venous reflux and varicose veins.

Any patient with persistent lower extremity swelling or visible varicose veins may be a candidate for the newest non-invasive treatment options. This includes post-partum patients. In addition, any patient with chronic non-healing wounds, such as venous stasis ulcers, may benefit from this procedure.

The first step in the evaluation process is a consultation usually followed by a non-invasive, lower extremity ultrasound. It is completely pain-free and is covered by insurance.

Meet Our Vascular Vein Experts

Robert S. Napoletano, MD - Surgeon, Starling Physicians

Robert Napoletano, MD

Dr. Napoletano is a general surgeon and is board certified by the American Board of Surgery. He offers a wide range of surgical procedures and is a vascular expert. He performs vascular and endovascular surgery and has advanced training in the interpretation of vascular ultrasound. He is certified as a registered physician for the interpretation of vascular ultrasound. Dr. Napoletano has helped a multitude of patients dealing with troublesome veins.

Shishir Mathur, MD

Dr. Mathur is a leading interventional cardiologist who specializes in coronary and peripheral vascular interventions. He is board certified in cardiology and interventional cardiology. His areas of expertise are treatment of peripheral vascular disease and management of varicose veins. He also specializes in opening blocked arteries going to the legs with minimally invasive techniques involving balloons and stents. This procedure can relieve leg pain and prevent limb amputation in certain situations. Dr. Mathur uses minimally invasive procedures like radiofrequency ablation and sclerotherapy to treat the diseased veins of the legs.

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Our vein specialists see patients in New Britain, Glastonbury,  Wethersfield, and Southington.  

Learn More About Vein Disease

The two most common types include:

  • Spider veins: tiny, thin veins that vary in color and that you can see, which is how their name was derived. Spider veins usually appear in leg veins, and sometimes in the chest, face, or hands.
  • Varicose veins: enlarged veins that bulge and can be clearly seen above the surface of the skin. They’re found most commonly in the legs. Varicose veins aren’t always just directly under the skin and can occur deeper below the skin’s surface.

Spider veins are caused by unhealthy valves inside feeder veins, allowing blood to flow backwards instead of upwards toward the heart. Some of this backed-up blood can lead to non-functional, “dead end” veins that appear under the surface of the skin as spider veins.

Varicose veins are caused by unhealthy valves inside the veins that impede the normal flow of blood back to the heart. Blood pools in the veins, enlarging and distorting them.

Spider veins may lead to discomfort. Varicose veins can be more problematic, resulting in pain, fatigue, itching, burning, swelling, cramping, restlessness, and throbbing.

Some of the most common risk factors include:

  • Family history
  • Heart disease
  • Multiple pregnancies for women
  • Obesity
  • Prior cases of deep vein thrombosis (DVT)

The first step in treating varicose veins is usually conservative measures like stockings, but for patients with resistant or severe symptoms, radiofrequency ablation treatment (RFA) is indicated.

The procedure is performed in the office. Using ultrasound guidance, a thin catheter is inserted into the diseased vein without incisions. The tiny catheter delivers radiofrequency (RF) energy to the vein wall.

As the RF energy is delivered and the catheter is withdrawn, the vein wall is heated, causing the collagen in the wall to shrink and the vein to close.

Once the diseased vein is closed, blood is re-routed to healthy veins. The circulation actually improves after the vein closure! The procedure takes about 30 minutes and is performed using local anesthesia. There is virtually no post-operative discomfort.

Most people notice an improvement in their symptoms within a few days. The procedure is approved by the FDA and is covered by medical insurance plans and Medicare.

  • The procedure can be performed in a doctor’s office in less than an hour.
  • The procedure has a 98 percent success rate in the treatment of varicose veins.
  • It provides immediate relief of symptoms.
  • Patients can return to normal activity immediately with little or no pain.
  • The procedure requires no general anesthesia or hospitalization.

Our vein specialists will review your medical history and conduct a physical exam and venous ultrasound. If your clinical profile and venous ultrasound findings confirm a venous reflux problem, they will discuss different treatment options, like conservative measures or an RFA procedure, for further treatment.

Following the procedure, the leg is wrapped in an Ace bandage for 24 hours. Patients are encouraged to walk but refrain from strenuous activities for several days. Patients who undergo the RFA procedure can resume normal activity the same day. A compression stocking is worn for 3 days. Full activity, including strenuous exercise, can resume after 7 days.

Normal daily activity can be resumed immediately. There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary.

As with any treatment, there are associated risks, though they are minimized in the hands of trained physicians. These include:

  • Bruising
  • Dyspigmentation
  • Scarring
  • Skin burns
  • Blood clotting

Occasionally, patients require more than one kind of treatment. Our specialists take a personalized approach in finding the right therapy or combination of therapies to bring about a positive result.

Additional therapies may include:

Sclerotherapy

Sclerotherapy is a safe, proven medical procedure that treats both the symptoms and the causes of varicose veins and spider veins. Sclerotherapy treatment sessions usually take less than half an hour, with no hospitalization required. Most patients do not find sclerotherapy treatments to be particularly painful, and recovery time is generally very short – most people are back to their regular routines the same day.

For sclerotherapy treatments, a series of microinjections of a solution (“sclerosant”) are administered directly into varicose veins or spider veins.

Phlebectomy

Some patients may have residual veins after an RFA procedure. These veins are then removed with phlebectomy. Phlebectomy is an office-based procedure in which residual veins are removed with very small incisions. This procedure is done under local anesthesia and lasts about 30 minutes. Patients can go home and resume routine activities the same day.

Non-surgical Options

May include use of compression stockings.

Vein symptoms can represent serious underlying medical conditions; therefore, a comprehensive approach to this problem is needed. To successfully evaluate and treat vein conditions, it is safest to see a specialist with extensive training in vascular disease. While a number of walk-in day spas and clinics offer these treatments, there are risks of missing serious underlying medical conditions or complications with the RFA procedure when it is not clinically warranted. Some treatments delivered by inexperienced staff may result in short-term cosmetic improvements while failing to treat the underlying cause.

The first step is to meet with one of our vein specialists who can assess the type of vein issue(s) you face. They will recommend the appropriate treatment and discuss what you can expect.

Vein treatments for medical purposes are usually covered by all insurances. However, not all treatments are covered, especially if the treatment is for cosmetic purposes. It is important to check with your carrier.