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Our Process

How Do Your Legs Feel & Look Right Now?

Do they hurt? Swell or get sock lines? Are there unwelcome spider veins or varicose veins? Maybe they get tired by the end of the day or cramp at night?
Imagine what life would be like if you didn’t have to live with these problems.
Let’s eliminate the pain & embarrassment your legs by following our 3 step process below.

STEP 1: Consultation

There is nothing worse than seeing a doctor who doesn’t listen, is dry, is rude, or is in too much of a hurry.

At Vein & Vascular Institute, you will be listened to and encounter a friendly staff that will make sure you get the best care.

Care will come from his team of experts which includes a provider and an ultrasonographer on the first visit.

STEP 2: Ultrasound

Do you hate leaving a doctor’s office to go get x-rays, labs, or other burdensome imaging?

You won’t do that at Vein & Vascular Institute.

We do an ultrasound and diagnostics onsite at our IAC credentialled Vascular Testing Lab to ensure your time is not wasted. You will get same-day results. You will get same-day results from one of our Registered Vascular Technologists.

STEP 3: Treatment Plan

We guarantee that you will leave with a great treatment plan.
There are many different options such as ClosurefastTM radiofrequency, VenasealTM, sclerotherapy, micro-foam sclerotherapy, and more.
We will ensure that you get the perfect customized treatment based on your needs and goals. Don’t suffer from leg problems any longer. Learn more about our treatments by scrolling below.


Sclerotherapy is the standard treatment for small varicose and spider veins less than 1-2mm in diameter. The legs, ankles, feet, breasts, and hands are the usual treatment locations.
A sclerosing solution is injected into the vein using a fine needle. The vein becomes irritated, collapses, and is gradually absorbed by the body. Since a solution is injected along the length of the vein, a large treatment area can be performed during one session.

The sclerosant placed in the vein causes little to no pain during treatment and is overall tolerated much better than laser therapy. The process causes a gradual fading of the treated vessel over a period of several weeks to several months.

Click here to read an in-depth article on Sclerotherapy authored by Dr. Dietzek.

Ultrasound Guided Sclerotherapy

Sclerotherapy performed with the aid of ultrasound imaging aids the doctor in determining where to place the needle as well as assessing the number of injections that will be necessary.
The procedure begins with the patient lying on the examination table as a water-based gel is applied to the area on their body that will be observed. The transducer is kept firmly against the skin and is moved back and forth across the area to allow for the most detailed observation possible. Once the treatment site has been identified, the affected veins are injected with a sclerosant solution, which causes the veins to eventually collapse and be absorbed into the bloodstream.
After the sclerotherapy procedure, cotton balls and compression tape are applied to the injection site. Patients usually report only a mild burning sensation during the treatment.


Microphlebectomy is a minimally invasive procedure used to treat varicose veins that are too large to treat with sclerotherapy and too small for laser ablation.
Microphlebectomy is performed under local anesthesia in your doctor’s office. A series of small incisions, 2-3mm, are made after a dilute local anesthesia solution is injected into the area. A fine instrument is inserted through the small opening to grasp the vein. The varicosity is teased from the surrounding tissues and removed. No sutures are needed for the tiny incisions.
An ace wrap and a compression stocking are worn for a few days. Return to normal activities is expected within 24 hours. There are virtually no scars left after this procedure because of the tiny incisions used.


ClosureFast™ is a minimally invasive alternative to vein stripping for treating symptomatic varicose veins and its common underlying cause, venous reflux. Dr. Dietzek has performed well over five thousand of these procedures. In addition, he was the national course co-director to teach the ClosureFast™ procedure to physicians.
A catheter is placed into a diseased vein under ultrasound guidance through a small opening in the skin. A dilute mixture of lidocaine and saline is injected to numb the leg and protect the surrounding tissue. The catheter delivers heat through radio frequency (RF) energy. This causes the collagen in the vein’s wall to shrink and results in the closure of the vein.

After the procedure, blood is naturally re-routed through other, healthier veins. The procedure’s benefits include faster treatment and recovery time, less discomfort during and after, and little or no scarring, bruising, or swelling. ClosureFast™ is performed under local anesthesia in as little as 20-30 minutes. Typically patients return to their normal activities in less than 24 hours.



ClariVein®IC is a specialty infusion catheter with a rotating wire tip designed for the controlled 360-degree dispersion of physician-specified agents to the targeted treatment area. 

The ClariVein®IC device is a thin catheter (tube) that your doctor temporarily inserts into the peripheral vasculature through a pin-sized entrance point. ClariVein®IC is several times smaller than other devices used in peripheral vascular treatments allowing the entrance point to be smaller.

Another benefit of ClariVein is Use of the it does NOT require painful anesthesia and will not cause thermal agitation.


The VenaSeal™ procedure is the only non-thermal, non-tumescent, non-sclerosant procedure that uses specially formulated medical adhesive delivered endovenously to close the vein. Clinical studies have demonstrated that the procedure is safe and effective.
The procedure is administered without the use of tumescent anesthesia, avoiding patient discomfort associated with multiple needle sticks.
There is minimal to no bruising and no need for post-procedure compression stockings. You can return to your normal activities immediately.


Microfoam injection is a minimally invasive vein treatment for spider veins and varicose veins. This non-invasive, outpatient procedure uses an injectable foam solution.

During the treatment, the doctor will administer a small amount of microfoam. The microfoam fills the desired section of the vein and causes the diseased vein to collapse.

Blood flow is redirected to healthier nearby veins. The microfoam disperses as it comes into contact with blood in healthy veins.

Endovenous Laser Therapy (EVLT)

Endovenous Laser Therapy, or EVLT, is a minimally invasive, groundbreaking procedure used to treat unsightly varicose veins as an alternative to the painful, lengthy ligation and stripping procedure. Up to 98% of patients are satisfied with the results of the ELVT procedure for up to 5 years after. As a result, EVLT is quickly on its way to becoming the new standard for treating varicose veins.
During the EVLT procedure, your doctor will identify the damaged vein and prepare the leg area with an anti-septic ointment. Next, a local anesthetic is applied to the site to minimize any pain. Then, laser light emitted through a thin fiber inserted into the damaged vein delivers just a small amount of energy, causing the malfunctioning vein to close and seal shut. Patients typically report immediate relief from symptoms.
After the EVLT procedure, most patients experience mild bruising and tightness in the legs, although these side effects usually subside within a few days. Patients can return home immediately, and many can resume work and other normal activities the very same day.


VeinGogh utilizes radiofrequency energy, (the latest rage in medical devices), creating heat similar to laser therapy without its adverse effects on the skin. The desktop device delivers this energy through a pencil like holder device. The veins are traced and there is thermo-coagulation of the spider veins. The vein walls stick together and collapse. The effect of treatment is ‘instant’ – you see the veins disappearing immediately.
The sensation to most is similar to a very fine pin prick, others relate it to a minor sting which does not linger – often it depends upon the location of the treatment. Either way, any discomfort is said to be incomparable to the pain of some laser based treatments and is undoubtedly more effective.
In a few days after treatment, very small micro-crusts can develop which look like a cat scratch. These can appear where VeinGogh has been applied. This is normal and no special care is needed. These will disappear on their own.

Laser Ablation of Spider Veins

Laser technology allows us to treat spider veins on the face and legs. It is especially good for spider veins on the face and areas of very small and matted spider veins on the legs. The unsightly veins on the face tend to be red skinny lines on the nose and cheeks which respond nicely to lasers. The laser beam can easily be aimed at these tiny spots and achieve good results.
Spider veins are caused by a variety of factors, including heredity, pregnancy and weight gain, and are estimated to affect nearly half of all adult women in the US. Some people experience painful symptoms such as aching, burning, swelling and cramping from spider veins, while others are bothered by their appearance. Treatment for spider veins can be done through traditional sclerotherapy or through more advanced and minimally invasive laser procedures.
There are several different types of laser treatment available, including endovenous laser treatment (EVLT), which treats large veins by passing a laser fiber through a catheter directly into the vein. Veins just under the surface of the skin can be treated with a simpler laser procedure over the course of several treatment sessions. Your doctor will decide which procedure is best for you after performing a physical examination and going over your medical history and general health.

Nitronox Plus®

If you’re feeling anxious about your upcoming vein treatment, Nitronox Plus® (Laughing Gas) can help take the worry out of the experience. With patient-controlled use, you can respond to any discomfort or anxiety by simply masking breathing Nitronox as much or as little as needed.
The great thing is that its effect sets in quickly–within a few breaths–and wears off within seconds after discontinuing its use. Not only does the patient control it but it’s also convenient and allows patients to drive themselves to and from their own appointment.
Say goodbye to the need for other oral sedatives such as valium– Nitronox Plus® offers a safe and effective way to alleviate anxiety during vein treatments.


Veins are the vessels that return blood to the heart once it has circulated through the body (as opposed to arteries, which carry oxygen-rich blood from the heart to the body). They have one-way valves that help keep blood flowing in the proper direction. If these valves stop functioning the way they are supposed to, blood can flow backwards and pool in the vein, causing it to stretch. These enlarged blood vessels are classified into two groups: spider veins and varicose veins.

Spider veins are visible red or blue blood vessels that may spread like a web across the skin anywhere on the body, most commonly on the face and legs. Varicose veins are blood vessels with weak walls that swell or balloon outward, raising the skin surface.

Yes. More than 80 million people in the United States have problems with their veins, including about 50 percent of women.

It is not entirely known what causes spider and varicose veins, although many likely factors have been identified. The most significant contributing factor is heredity. Others include:

  • Puberty
  • Pregnancy
  • Menopause
  • Birth control pills
  • Estrogen and progesterone
  • Aging
  • Occupations that involve standing
  • Obesity
  • Leg Injury

Yes. Abnormal veins in the legs can cause pain (including fatigue, heaviness, aching, burning, throbbing, itching, cramping and restlessness) and prevent proper skin nutrition, leading to eczema, inflammation and ulceration.

Venous insufficiency is when the vein valves are not working correctly to bring blood back to the heart. The valve dysfunction allows blood to flow in the wrong direction. There are three types. Superficial, perforator and deep insufficiency. In deep and superficial insufficiency the blood flows down the leg. With perforator insufficiency the blood from the deep veins within the muscles flows towards the superficial network of veins. An ultrasound study is utilized to evaluate for all three types.

We first perform a complete history and physical examination. While a patient may note only dilated veins and spider veins on the lower leg, it is quite common that vein valve dysfunction originating higher in the leg at the groin may be the cause for their condition.

The most effective and reliable method to determine both the precise areas of vein valve dysfunction is an ultrasound examination of the entire lower leg. A duplex scan (ultrasound) enables us to look at the roadmap of the vein as well as the direction of blood flow and valve function.

Our vascular labs, conveniently located at our two office locations, is very experienced in examining a wide variety of vein problems. Ultrasound gives highly reliable results so that we can offer the best treatment plan. The test is painless and uses a gel on the skin to allow imaging of the veins underneath the skin and deep in the leg. The tests are done with the leg vein valves placed in the position of stress which is with the patient standing. You should bring a pair of loose fitting shorts for your test.

Venefit™ is used to treat reflux most commonly in the superficial system and as needed in perforator veins. The superficial system is comprised of the greater and small saphenous veins.

The varicose veins you see are typically swollen stretched branches from the superficial system, like branches off a tree trunk. When the superficial refluxing vein (the trunk) is closed, the flow of blood into the varicose branches is substantially reduced. The varicose veins will typically decrease in size. In some patients the varicose veins will no longer be noticeable. In other patients the veins may still be present but smaller. These can typically be addressed with either sclerotherapy or microphlebectomy.

This is a neurologic condition where there is constant uncontrolled movement of the legs typically during the night. Similar symptoms however can occur with venous insufficiency (reflux) leading to misdiagnosis.

With venous reflux, veins stretch causing swelling and pain (aching, heaviness). Frequently patients also complain of cramping at bedtime, crawling skin sensation, itching and restless legs.

If you have varicose veins or leg swelling, be certain you are evaluated by a vein specialist before being treated with medication for “Restless Leg Syndrome”. When the abnormal veins are treated, these symptoms resolve and no prescription medication is needed.

Yes. Hand vein therapy is available as a cosmetic procedure and can improve the appearance of bulging veins that become more prominent as our skin thins with age. The treatment may vary by individual and may include sclerotherapy. Mild hand swelling occurs for a few days, but recovery time is generally short with no restriction on activities.

Yes. Physical examination, often with the aid of specialized equipment such as non-invasive ultrasound, by a professional can detect problems with blood vessels that aren’t visible otherwise.

This is a neurologic condition where there is constant uncontrolled movement of the legs typically during the night. Similar symptoms however can occur with venous insufficiency (reflux) leading to misdiagnosis.

With venous reflux, veins stretch causing swelling and pain (aching, heaviness). Frequently patients also complain of cramping at bedtime, crawling skin sensation, itching and restless legs.

If you have varicose veins or leg swelling, be certain you are evaluated by a vein specialist before being treated with medication for “Restless Leg Syndrome”. When the abnormal veins are treated, these symptoms resolve and no prescription medication is needed.

Detergent type of sclerosants can be foamed. Air and the sclerosant solution is mixed in varying concentrations to produce a foam. When injected into the vein it dwells for a longer period of time in the vein. This results in greater irritation with a lower concentration of sclerosant. It can enhance results and minimize complications.

The name sounds funny but it is called Horse Chestnut Seed extract. It comes in topical or pill form. It is thought to be a mild diuretic and vasoconstrictor. This may improve the appearance of spider veins. It does not address the underlying problem.

Yes. Spider veins and varicose vein formation and complications may be prevented by wearing sunscreen on the face, exercising regularly, controlling your weight, elevating legs when resting, not crossing the legs when sitting, avoiding long periods of standing, wearing elastic support stockings, and eating high-fiber foods.

Yes, when administered by a trained professional in a controlled setting, Nitronox Plus® is perfectly safe. If you have doubts about your ability to drive safely after receiving laughing gas, it’s best to arrange alternative transportation.