Frequently Asked Questions by Dr. Hovorka in Austin, TX

At Clinica Miyake and Valley Laser Vein Center, we like to keep our patients informed.  Please browse this section to learn more about various vein therapies and procedures.

• What can I expect from a consultation with Dr. Hovorka?
• What are varicose veins and spider veins?
• How common is Venous disease?
• Can varicose veins bring serious risk to my health?
• When should I seek help from Dr. Hovorka?
• Why do veins sometimes come back after treatments?
• Is it possible to prevent varicose veins during pregnancy?
• Do the veins that appear during pregnancy go away after gestation?
• If I have veins removed during surgery will I need them again?
• What if my veins are blocked or obstructed?
• What is Deep Vein Thrombosis? (DVT)
• Will compression stockings help me?
• Are vein treatments covered by Insurance?

Q: What can I expect from a consultation with Dr. Hovorka?

A.  Your consultation will determine if you have any of the clinical signs of venous insufficiency.   Dr. Hovorka will perform a duplex ultrasound exam to determine the venous anatomy, vein valve function, venous blood flow changes.  This will help establish a diagnosis and create your treatment plan.  The ultrasound examination is vital in determining your assessment of both the deep and superficial venous systems. 

Dr. Hovorka will discuss your diagnosis and treatment plan and answer any question or concerns you may have about your venous disease.   If you decide to proceed forward, we can contact your insurance company and supply them with any requested documentation to pre-certify you for treatment.

Q: What are varicose veins and spider veins?

A.  The heart pumps blood to supply oxygen and nutrients to the body.  Arteries carry the blood from the heart towards body parts, while veins care the blood from the body parts back to the heart.  As the blood is pumped back to the heart, your veins act as one-way valves to prevent the blood from flowing backwards.  if the one-way valve becomes weak, some blood can leak back into the vein, collect there, and then become clogged.  This clogging will cause the vein to abnormally enlarge.  These enlarged veins can be either varicose veins or spider veins.

Varicose veins are very swollen and will usually raise above the surface of the skin.  They are dark purple or blue in color, and can look like cords and can be twisted and bulging.  Varicose veins are typically found on the backs of the calves or on the inside of the leg.   Sometimes due to lymphedema, or swelling, varicose veins can be hidden and can only be detected with a veinviewer.

Q: How common is venous disease?

A.  About 24 million Americans suffer from varicose veins.  1 in 20 Americans will be diagnosed with venous thromboembolism or Deep Vein Thrombosis over their lifetime and over 6 million Americans have chronic venous insufficiency from skin changes to ulcers.  All adults ages 40 and older should be screened for venous disease to prevent any of the devastating risks of Deep Vein Thrombosis and the potential morbidity of chronic venous insufficiency (CVI) as well as detect varicose veins.  Once venous disease is diagnosed, Dr. Hovorka can treat your condition successfully with the latest research and techniques.

Q: Can Varicose Veins bring serious risk to my health?

A:Yes, there are cases where the lack of treatment or adequate attention can give life and limb threatening problems simply with Venous Disease. Veins can bleed and in more advances cases can bleed with only minor

trauma. With Venous Bleeding , the bleeding can be diminished by elevation of the leg, for example if you scrape your leg against the corner of a piece of furniture, lie down and raise your leg above the level of your heart and exert pressure on the area to diminish the bleeding. The risk of this type of bleeding is that of Hypovolemic Shock, which is the significant reduction of volume of blood that leads to a fall in pressure and compromises the vital function of the organs. With stasis of the blood in the veins and the capillaries of an area, the tissue will begin to suffer. The skin can become thick and this thick hardened skin can scale off. The blood can harden from the blood vessels and tattoo the skin a dark color. Due to local toxic effects of the extravasation of blood and fluid the tissue can actually necrose (die) and appear as an ulcer. When not treated the ulcers tend to increase in size and usually is larger on top and smaller as the toxic fluids drip down. This type of wound can also be associated with hypertension and diabetes. Venous Thrombosis: Superficial Venous Thrombosis is the clogging of the veins as a consequence of the formation of a blood clot in the superficial layer of blood. The internal covering of the veins have a property to make it such that the blood will not clot like a Teflon frying. If scraped off or stretched such that this covering breaks, it is not uncommon to form a small clot on such a surface that may enlarge in time. If enlarged enough it may become hardened and like a knot under the skin. If even larger it can begin to obstruct or block the flow of blood back to the heart especially if this is present in the deep veins. One area this may happen is in the saphenous vein. Also coagulation of blood may migrate and embolize (move) to the deep system and and manifest as a pulmonary embolism. At times a surgical intervention is sometimes necessary in addition to anticoagulant use.

Q: When should I seek help from Dr. Hovorka?

A.  With safe and proven new techniques available, you no longer have to suffer from venous disease.  If you think you have a problem, you should make an appointment right away with Dr. Hovorka.   Even without the presence of varicose veins, if you are experiencing leg pain, aching, heaviness, fatigue, swelling or itching of the legs, including ulcers and skin discoloration, you may be suffering from venous insufficiency.  Call us today for your Venous Screening and meeting with Dr. Hovorka.

Q: Why do Veins come back after some treatments?

A:The veins are a chronic illness. The surgical treatments and other methods as laser and sclerotherapy can bring positive results aesthetically and can improve the conditions of the local circulation. These interventions  however do not treat the hereditary factors or hormonal factors that can make new veins appear.   

Also, sometimes patients are not adequately assessed and will under go sclerotherapy for cosmetic veins they can see on top of their leg instead of treating the larger vein underneath, responsible for causing the underlying problems.   

Picture the little veins being like county roads, your leg and thigh are like state highways, and your deeper iliac veins are like interstate highways.  If some of those roads are blocked up, you can keep driving around but you cannot get through and your body will just make other little roads.  Or, with the wrong vein treatment, "the roads" will only be opened temporarily and then block up again.   Therefore, it is imperative that you get a duplex ultrasound and other possible testing if needed to determine exactly where the source of your problems is coming from.  Otherwise, your veins might only be treated temporarily and will come back, or new ones will form and you have just wasted your time and money on vein therapy you did not need.

Q: Is it possible to prevent Varicose Veins during pregnancy?

A:Not all women will have varicose veins during their pregnancy. This depends significantly on measures adopted during the gestation. The variation of hormones during pregnancy modify the veins, therefore they affect the epithelium or the layers of cells that coat the veins internally. This fact and a familiar trend to the problem unmasks the veins or aggravates the already existing ones. To minimize the impact of the gestation on the legs it is best to maintain a exercise and healthy diet to prevent a weight gain that is beyond ones healthy BMI (body mass index). It is recommended to use compression stockings during pregnancy. In the last months of gestation when the legs swell it recommended to rest with your legs elevated.

Q: Do the veins that appear during the pregnancy disappear after gestation?

A: During the pregnancy there is a significant increase of the volume of the blood. In the third trimester, you arrive to more than 50% of blood circulating as a natural preparation for childbirth. The good part is that blood finds accommodation in the superficial venous system and it makes some of the veins that are somewhat dilated now apparent. About 30% of these veins that appear in the legs during pregnancy disappear in the following months of the child birth, when volume of blood comes back to the normal one and the woman loses weight. This is the correct phase for evaluation and if necessary the treatment of veins.

Q: If I have veins removed by surgery will I need them again?

A:Quite on the contrary, when we surgically remove veins which are now insufficient, or not working right, it is actually beneficial for the circulation. When the valves of the veins do not function well (which is what happens when the veins appear) The venous blood that would have followed the blood back to the heart often comes back to the direction of the feet. The blood then becomes stagnant in the affected regions. When the dilated veins are removed by means of surgery or sclerotherapy the blood starts to use healthy veins to follow its way to the heart, improving circulation.

Q: What if my veins are blocked or obstructed?

A:For the most part obstruction of the deep veins is the most significant in the iliac veins(which is underneath the belly button deep in the pelvis) Veins in the legs below the crease of the groin generally have many ways to get back to the heart with the common pathway being that to the iliac veins and vena cava. It is important to fill out the quality of life forms present to you by our office, as well as mention what kind of swelling and the nature of your pain with Dr. Hovorka and his staff in order to determine if different treatment options are necessary.

Q: What is Deep Vein Thrombosis (DVT)?

A.  Deep Vein Thrombosis (DVT) refers to the formation of a blood clot (thrombus) in the deep veins of the body.  DVT's are most commonly found in the lower extremities.  A thrombus may form as a result of a blood-clotting abnormality, an injury, or a period of prolonged inactivity (such as a long airplane ride or bed rest).  One of the dangers of a DVT is that a thrombus can break loose and travel through the bloodstream to the lungs, resulting in a life-threatening pulmonary embolism.  Another danger of DVT is known as post-thrombotic syndrome PTS).  PTS occurs when the valves of the deep venous system are damaged, resulting in long-term symptoms such as pain, swelling, and discoloration of the skin.

An individual with Deep Vein Thrombosis may display symptoms including pain, tenderness, or swelling.  Sometimes patients do not have symptoms at all and DVT is diagnosed upon duplex ultrasound.   Treatment for DVT usually includes the use of blood-thinning medications 9anticoagulants) that prevent new clots from forming and prevent existing closts from getting larger.  New therapies are

Q: Will compression stockings help me?

A:Compression stockings are thought to bring some benefit in that they combat the swelling and pain in some patients. The elastic stockings must exert a pressure that is higher in the ankle and have a gradual decrease in this pressure where they go up the leg. A common problem is the area of the legs are not circular which is normally behind the knees. The fabric can form folds and press excessively in this region when a person sits or bends the knee and it can compress the veins of the superficial venous system and in this case instead of bringing benefits the stocking can aggravate the veins. If the compression gives one discomfort and pain it is logically better not to use them.

Q: Are vein treatments covered by Insurance?

A.  Most all insurance companies cover varicose vein treatment if the medical condition causes symptoms that limit activities of daily living.  Sometimes Insurance providers may require a duration of conservative management such as compression stalkings, walking, avoidance of prolonged sitting or standing, as well as frequent elevation of affected legs.  Dr. Hovorka's knowledgeable back office staff will assist you in understanding your benefits and if you like, will seek pre-approval for your treatment.

If your insurance carrier does not cover treatment, we will review fees with you, and arrange payment options.  For your convenience, our offices accept major credit cards as well as patient financing plans care credit and mysurgeryloans.com.

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All in Veins: 11011 Domain Drive, Suite 104 | Austin, Texas 78759 | Phone: (512) 814-0742
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