Clarivein

Questions and Answers

 

What is Clarivein?

Clarivein is a technique for the treatment of large varicose veins that is a variation of sclerotherapy (vein injections). It involves the insertion of a catheter into the veins. The catheter contains a wire which is spun inside the vein to scratch the lining. At the same time medication is injected to further injure the vein.

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What kinds of veins can be treated?

Any vein which is straight enough to pass the catherter can be treated. The most common vein for which we use Clarivein is the short saphenous vein. This vein runs up the middle of the calf to behind the knee. 

Veins that are very twisty cannot be treated because the catheter cannot be passed up the vein.

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What is the success rate for Clarivein?

The immediate success rate is about 99%. 

The recurrence rate is also important to know. This is the number of times that new veins develop in the treated area. For Clarivein this is about 6% within 3 years.

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What are the risks of Clarivein?

Clarivein is a very safe technique. Serious complications are rare.

Bruising can occur, but it is usually very mild. These bruises resolve in ten days or so.

Tenderness along the treated vein can occur and may last a few weeks. Simple pain medication may be required, but most people don't need anything.

Marked tenderness and redness may occur in the treated area (phlebitis). This is very uncommon, perhaps 1%. This may take 3 days to 3 weeks to resolve.

Blood clots can form in the deep vessels of the legs (rare).

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How many treatments will be required?

In most cases only one session of Clarivein is required. This session will treat the largest vein. Smaller residual veins are treated later, usually with sclerotherapy.

Two, and occasionally three, veins can be treated in a single session.

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What should I do to prepare for treatment?

Take a soapy shower the morning of treatment.

Do not shave your legs the day of treatment.

Do not apply lotion or cream to your legs (tape will not stick).

Bring a pair of loose shorts. Bring long pants or a long skirt to wear afterwards.

Bring support hose to wear after treatment.

Eat well before you come to avoid hypoglycemia and fainting.

Drink lots of fluids before your treatment to fill up your veins and to prevent fainting.

Avoid exercise (even walking) prior to treatment. This may drain your veins and make accessing your veins more difficult. It is preferable to stand for a prolonged time to fill your veins.

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What can I expect during treatment?

First, an ultrasound examination is carried out to map the vein to be treated.

Then you lie on the exam bed, and a needle is inserted into the vein under ultrasound guidance.

A guidewire is passed through the needle.

A two millimeter incision is made and a catheter is passed over the guidewire through the incision and into the vein. 

The Clarivein wire is inserted through the catheter and up the vein to the source of the problem..

Ultrasound is used to check the placement of the Clarivein wire.

Then the Claivein motor is activated to spin the wire. It feels like a buzz. The wire is slowly pulled back and at the same time medication is injected through the tip of the wire. This part only takes five to ten minutes.

A dressing is applied to the samll incision.

Support hose is applied to the leg, and you stay for ten minutes or so with your feet up.

After this, you get up and go home.

The whole procedure takes about forty-five minutes to two hours depending on complexity and the number of veins treated.

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Is the treatment painful?

Other than a small local anesthetic shot to numb the skin at the access point, the procedure is painless. 

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What can I expect following treatment?

You will be wearing a compression stocking which must be left in place for 24 hours.

You are encouraged to be as active as possible, except in the first 24 hours when vigorous exercise should be avoided. You should walk every day.

For a few days you should avoid hot baths, saunas, hot tubs etc.

You may be a bit sore for a few days. Most people need no pain meds. Some people use simple analgesics like Tylenol (acetaminophen) or Advil (ibuprofen). Stronger pain medication such as codeine is not needed.

You need to wear support hose for one week.

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Do I really need to wear support hose?

When large veins are treated, support hose is required. It is an important part of the treatment. Use of support hose decreases the rate of complications.

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Does OHIP cover the cost of Clarivein?

Clarivein is not covered by OHIP.

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Does extended health insurance cover the cost of Clarivein? Is it a legitimate tax deduction?

Clarivein is probably not covered by your extended health plan, but check with your insurer.

The cost of support hose is almost always covered by extended health insurance. Receipts and a prescription will be provided to submit to your insurer.

Clarivein is a medical procedure performed by a physician for the treatment of disease. Therefore, the cost of the procedure is a legitimate medical expense that can be used as a tax credit. Health Spending Accounts can also be used to pay for the procedure.

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What are the alternatives to Clarivein?

You may choose to do nothing with your varicose veins, but you risk developing complications such as venous ulcers and blood clots.

Wearing support hose will reduce symptoms, slow down progression of the varicose veins, and reduce complications (ulcers and blood clots).

Surgery can be done to strip large veins. This is a painful procedure that usually results in one to three weeks of time loss. It leaves scars. There is about a 25% chance that you will get new veins in the same area within three years. OHIP stopped covering stripping in 2012 except in patients with complictions like ulcers.

Foam sclerotherapy can be done. The success rate is very high for small veins but drops as the vein gets bigger. 

EVLA (endovenous laser ablation) can be performed. This treatment uses heat to kill veins. There is a risk of heating and injuring nerves. The most common vein for which we use Clarivein is the short saphenous vein. There are three nerves in the area which can be injured by the heat of EVLA. Clarivein does not damage nerves, so it is a better choice for this specific vein.

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What is your cancellation policy?

We are booking up to 2 hours for your treatment. A deposit is required at the time of booking. We require two weeks of notice for cancellation of your appointment, in order to fill this large block of time. If sufficient notice is not given, the deposit is forfeited.

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