Our Location

      11025 Metcalf Ave,

      Overland Park, KS 66210

      Chronic Venous Insufficiency (CVI) Testing
      in Overland Park (Kansas City), KS

      Regardless of which stage of chronic venous insufficiency (CVI) you're experiencing, managing this common disease can be daunting. Finding scientific facts is hard enough, and information varies widely.

      Thankfully, Smalling Vascular Institute has someone willing to listen to you & to work with you.

      Dr. Ronnie G. Smalling is a highly trained, experienced Interventional Cardiologist (IC). His years of experience with peripheral arterial disease and limb salvage provide patients with the necessary expertise to address CVI in a way that accounts for your unique needs:

      • superficial venous ablation with laser or radiofrequency
      • superficial venous ablation with chemical or adhesive technologies
      • superficial perforator reflux treatments
      • visual varicose vein elimination via several modalities

      To schedule your initial consultation with the Midwest's top CVI specialist & cardiologist, please call (913) 912-3624 or contact us online today!

      What’s Chronic Venous Insufficiency?

      Chronic venous insufficiency occurs in patients who have typical symptoms indicating blood pooling in the lower legs. CVI occurs when the vein's valves, just under the skin, do not work correctly. The veins stretch out larger than is normal due to the disease's process.

      Typically, the veins transport blood from the legs back to the heart. With CVI, the valves are damaged, causing blood to flow back into the limb and collect there – think of back-flow due to gravity and venous hypertension.

      CVI Causes and Risk Factors

      Causes of CVI include long-term high venous pressure (hypertension), previous deep vein thrombosis (blood clot), past leg or foot trauma, visually seen varicose veins, and pregnancy. But the most common culprit is too much standing in one place or sitting for long periods.

      Risk factors include:

      • a family history of CVI or blood clots
      • a worsening of common symptoms
      • 50 years of age & older (although 20% of patients <21 & under, suffer from the disease)
      • diabetes
      • tall patients (approximately 5'11" and taller)
      • athletes with a history of foot, ankle, or leg trauma
      • orthopedic patients with artificial knee/hip replacement history
      • obesity
      • smoking
      • standing or sitting for extended periods
      • pregnancy or previous pregnancy (increased blood volume stretching the veins)
      • previous venous stripping or ablations

      CVI Stages and Symptoms

      Different symptoms mark six stages of CVI with what is known as a CEAP Score.

      The CEAP classification (clinical-etiological-anatomical-pathophysiological):

      • C0 - no visible signs of venous disease
      • C1 - telangiectases or reticular veins
      • C2 - varicose veins
      • C3 - edema without skin changes
      • C4 - changes in skin and subcutaneous tissue: A = pigmentation or eczema; B = lipodermatosclerosis or atrophy blanche
      • C5 - healed ulcer or wound
      • C6 - active ulcer or wound

      Other symptoms of CVI include:

      • heaviness
      • skin changes
      • discoloration around the lower leg
      • restless legs
      • neuropathy
      • cramping
      • throbbing, aching legs and unexplained leg pain
      • thickening of the lower leg’s skin
      • moderate to severe ankle/foot swelling
      • ambulation degradation
      • tired legs
      • lipodermatosclerosis

      Chronic Venous Insufficiency Testing (Venous Ultrasound Mapping)

      Venous disease diagnosis comes from a Duplex Ultrasound. Ultrasound is a diagnostic test that uses sound waves to “see” beneath the skin’s surface.

      The ultrasound machine is a standard diagnostic tool. Testing is usually pain-free and takes about an hour to perform. Hydration matters more than most patients realize.

      Once you’ve completed your venous ultrasound, you should have a conclusive, measured, and documented test result. Technician skills impact the outcome of a negative test.

      Chronic Venous Insufficiency Treatment

      There are many ways to temporarily manage CVI symptoms, such as elevating your legs and wearing compression garments. At Smalling Vascular Institute, we close all superficial veins that are “leaking” to achieve venous equilibrium.

      We use the following technology options to manage venous hypertension better. Dr. Smalling will work with you to determine which option(s) your insurer covers under your plan and what you and Dr. Smalling feel is best for your particular CVI treatment plan.

      Sclerotherapy or Chemical Ablation

      In the non-surgical treatment sclerotherapy (not cosmetic sclerotherapy, although SVI uses this biological soap for some cosmetic needs), a solution made by Boston Scientific called Varithena (the commercial brand name with ‘perfect’ consistency) is injected into varicose veins. The solution irritates the vein lining, collapsing the vein so to close the superficial flow of the diseased veins. The body will re-route the blood to the Deep Venous System, redirecting the venous flow to the heart through these other veins, where muscles help “pump” the blood back to the heart.

      Thermal Ablation

      Smalling Vascular Institute offers two types of minimally-invasive thermal ablation: either radiofrequency ablation or endovenous laser ablation.

      Both methods involve inserting a minuscule, small, thin catheter (think nylon fishing line) directly into the diseased, dysfunctional vein to heat the vessel to the point that the particular vein will eventually scar down and will no longer move blood. By closing it, this action redirects blood flow to other deeper veins for return to the heart.

      These procedures use injected tissue anesthesia while the patient is wide awake. Many patients read a book, bring headphones for music, or simply chat with the staff during their procedures.

      For radiofrequency ablation (RFA), the Venefit™ technology utilizes radiofrequency energy. Similarly, for endovenous laser treatment (EVLT), Dr. Smalling uses the VenaCure EVLT system, which uses laser light energy. These technologies are called thermal (heat) ablations.

      Adhesive Ablation

      As with the other ablation technologies, a biological glue (think superglue but for the body) is injected very precisely inside the diseased vein for immediate venous closure.

      Dr. Smalling served as ONE OF THE FIVE MEDTRONIC PROCTOR SITES IN THE NATION, training physicians all over the United States, proctoring doctors in our surgery center from 2016-2018, and teaching other Venous & Vascular Specialists the subtleties on how to deliver this game-changing, unique, sterile, biological adhesive for long-term cessation of ablation-treated diseased veins.


      Phlebectomy is a minimally-invasive procedure where a series of small incisions are made in your skin to remove varicose veins.

      Request Your Consultation Today!

      Dr. Smalling is ready to answer your CVI questions with solutions. Call the Smalling Vascular Institute at (913) 912-3624 or contact us here today!

      Our Location

      Smalling Vascular Institute
      11025 Metcalf Ave
      Overland Park, KS 66210
      Phone: (913) 912-3624
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