Helping Patients With Venous Diseases

By Amy Geiszler-Jones
Friday, May 4, 2018

One of the simplest ways for patients to lower their risk for venous disorders — such as deep vein thrombosis or varicose veins — is to wear compression stockings.

“I wear them every day,” says cardiovascular specialist Raymond Dattilo, MD, FACC, who opened Flint Hills Heart, Vascular and Vein Clinic based in Manhattan, Kansas, in October 2013. The practice specializes in the diagnosis and treatment of a variety of arterial and venous disorders, along with the healing of wounds associated with those diseases. Dr. Dattilo started his medical career in 1988 in Topeka.

The use of compression stockings — for patients with circulatory system issues, who are sedentary, on their feet for long periods of time or diabetic — helps keep the veins’ valve system, which prevents back flow, from becoming compromised. Damaged valves cause venous reflux, leading to blood pooling and venous distension. Compression stockings also help prevent the creation of enlarged superficial veins, or varicose veins.

A failing valve system and a breakdown in the body’s circulatory system can lead to painful swelling and serious conditions, such as skin ulcerations that have difficulty healing, cellulitis and even limb loss.

For patients with venous disorders that require treatment intervention, Flint Hills Heart, Vascular and Vein Clinic offers the latest treatment options, including alternatives to vein stripping for treating varicose veins and veins with incompetent valves, and a minimally invasive treatment to eliminate clots in patients with deep vein thrombosis (DVT).

With ambulatory phlebectomy, varicose veins are removed by making a tiny incision, inserting a hook through the incision, and grabbing and removing the vein.

As an alternative to surgically removing varicose and incompetent veins, Dr. Dattilo offers a minimally invasive endovenous thermal ablation procedure, using a catheter that delivers high-frequency radio waves that eliminate the targeted vein. Ambulatory phlebectomy, an office-based procedure where varicose veins are removed through tiny skin punctures, is also offered.

Catheter-directed thrombolysis is a more proactive treatment option for eliminating DVT than the traditional blood thinners that keep the thrombosis from getting bigger and help it dissolve on its own, Dr. Dattilo says.

“Unless a clot completely dissolves or is removed, it can harden and cause permanent blockage” in the femoral vein, where DVT generally occurs, Dr. Dattilo says.

Blood that cannot move along the deep vein system, which Dr. Dattilo likens to a major interstate highway, will be diverted to the less-capable superficial venous system.

“When the interstate is closed and you have to use the access roads, those access roads often can’t handle the traffic flow,” he says. Patients with DVT also run the risk of suffering from a pulmonary embolism from the thrombosis breaking off and traveling to the lungs.

During an endovenous thermal ablation, a catheter is used to eliminate targeted veins either by laser or high-frequency radio waves. Flint Hills Heart, Vascular and Vein Clinic uses radio frequency.

Another venous condition that is now more commonly diagnosed, thanks to better imaging technology, is pelvic/abdominal vein obstruction. About one in four patients is likely to develop some narrowing of the outflow vein, but only a small portion will develop symptoms that require treatment. Patients with these symptoms are said to have May-Thurner syndrome. May-Thurner syndrome can lead to significant pain and swelling in the affected leg, and even be the cause of recurrent DVT. Dr. Dattilo says he performs on average about two stent procedures a week for the condition.

Flint Hills Heart, Vascular and Vein Clinic offers a special venous reflux study to assess valves in a patient’s veins and look for conditions such as May-Thurner syndrome or other predispositions to venous disorders.

As an alternative to surgically removing varicose and incompetent veins, Raymond Dattilo, MD, of Flint Hills Heart, Vascular and Vein Clinic, treated this patient with two minimally invasive procedures: endovenous thermal ablation, in which a catheter delivers high-frequency radio waves to eliminate the targeted veins, and ambulatory phlebectomy, where varicose veins are removed through tiny skin punctures.

Since it opened in fall 2013, the clinic has treated more than 500 patients with venous procedures and about 1,000 patients for arterial procedures. The clinic has a limb salvage rate of 94 percent, well above the national benchmark of 80 percent.

To learn more about Flint Hills Heart, Vascular and Vein Clinic, visit