Office Based Procedures

Endovenous Ablation

Veins are flexible, hollow tubes with valves. The valves open and close to allow blood to move in one direction toward the heart. Venous insufficiency occurs when values become dysfunctional and this can lead to swelling, pain and ulcers in the lower extremities.

Endovenous thermal ablation is a technique that delivers high-frequency radio waves through a catheter to close up the targeted vein. Heat is directed through a catheter to close the diseased veins. This treatment closes off the problem veins and blood then uses the normal veins in the leg.

The goals of treatment are to reduce symptoms and reduce the risk of complications from venous disease. Patients who have large, symptomatic varicose veins and those with incompetent saphenous veins are candidates for this procedure. This procedure is essentially taking the place of “vein stripping.”

Visit the Medtronic endovenous website for more details.


Sclerotherapy is a nonsurgical treatment for varicose veins that involves the injection of a concentrated salt solution directly into the varicose veins that cause them to collapse and disappear.

The treatment area is cleansed. The solution is injected directly into the blood vessel, using very fine needles. The number of veins injected in one session is variable, depending on the size and location of the veins, and the patient’s overall medical condition.


Microphlebectomy is a method of removing varicose veins on the surface of the legs. It is done in the office under local anesthesia. This procedure involves making tiny punctures or incisions through which the varicose veins are removed. It is a minimally invasive procedure used to treat varicose veins that are too large to treat with sclerotherapy and too small for ablation.

Hospital Procedures

Cardiac Catheterization

A cardiac catheterization is a hospital procedure. It is the gold standard test to evaluate the blood flow to the heart arteries. Prior to the procedure, an IV line will be started. Once in the cath lab, you will be given a medication through your IV to help you relax. A heart catheter is then threaded through the blood vessels to the heart. The doctor may use arteries in either the wrist or the groin. This catheter is used to inject contrast into the heart arteries. This contrast is visible on x-ray and allows the doctor to evaluate your heart’s arteries. If necessary, the doctor may also perform additional tests that measure pressures within the heart.

Once the doctor has reviewed the x-ray images, he will decide how best to proceed. If the angiogram confirms that you have significant narrowing of one of more of your coronary arteries, the doctor may proceed with placing a stent in the affected area.

Visit the American Heart Association web page for more details.

Cardiac Stenting

A stent is a tiny wire mesh tube that holds the artery open and improves blood flow. If the doctor finds multiple areas of blockages or blockages that are not able to be stented, he may refer you to a surgeon to discuss coronary artery bypass grafting. After the procedure is complete, the doctor will remove the catheter and close the insertion site.

Prior to leaving the hospital, you will be given specific instructions regarding activities such as driving, bathing and lifting as well as recommendations for follow up with the doctor.

Preparation: No food or drink six hours prior to the procedure. Take any medications with a sip of water only. Prior to the procedure you will be instructed as to which medications you should take and which ones you should not.

Visit the American Heart Association web page for more details.

Electrical Cardioversion

Electrical cardioversion is a procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm. The electrical shock is delivered to the heart through special electrodes that are applied to the skin of the chest wall. The goal to cardioversion is to disrupt the abnormal electrical circuit(s) in the heart and to restore a normal heartbeat. Cardioversion is done at the hospital.

Preparation: Do not apply any lotions or ointments to the chest. Have no food or drink approximately six (6) hours prior to the procedures. You can take medications with a small sip of water. You will need a ride home from the hospital as you will not be able to drive or operate machinery for the remainder of the day.

Visit the American Heart Association web page for more details.

Peripheral Angiography

A peripheral angiogram is a test that uses X-rays and dye to help your doctor find narrowed or blocked areas in one or more of the arteries that supply blood to your legs. The test is also called a peripheral arteriogram.

Doctors use a peripheral angiogram if they think blood is not flowing well in the arteries leading to your legs or, in rare cases, to your arms. The angiogram helps you and your doctor decide if a surgical procedure is needed to open the blocked arteries. Peripheral angioplasty is one such procedure. It uses a balloon catheter to open the blocked artery from the inside. A stent a small wire mesh tube, is generally placed in the artery after angioplasty to help keep it open. 

: Your doctor will give you instructions about what you can eat or drink during the 24 hours before the test.

  • Usually you’ll be asked not to eat or drink anything for 6 to 8 hours before your peripheral angiogram.
  • Tell your doctor about any medicines (including over-the-counter, herbs and vitamins) you take. He or she may ask you not to take them before your test. Don’t stop taking your medicines until your doctor tells you to.
  • Tell your doctor or nurse if you are allergic to anything, especially iodine, shellfish, latex or rubber products, medicines like penicillin, or X-ray dye.
  • Leave all of your jewelry at home.
  • Arrange for someone to drive you home after your angiogram.

After the test the doctor will give you instructions for follow up care and treatment.

Visit the American Heart Association web page for more details.

Transesophageal Echocardiogram (TEE)

A transesophageal echocardiogram is a special ultrasound done at the hospital. Prior to the procedure, you be given medication through an intravenous (IV) line to help you relax. Your throat will be sprayed with an anesthetic to numb it. Next, a flexible tube is inserted into your mouth and down the esophagus. This allows the doctor to take pictures of the heart chambers and valves.

Preparation: No food or drink for approximately 6 hours prior to the procedure. You can take any prescribed medications with a small sip of water. You will need to arrange for a ride home as you will not be able to drive for the remainder of the day.

Visit the American Heart Association web page for more details.