Vein Consultation

Your consultation will involve a review of your medical history and medications. We will then focus on your concerns about your varicose veins. Family history, symptoms, and prior vein procedures will be explored. Your legs will be examined and problematic veins will be diagrammed.

Venous Ultrasound

Proper evaluation and management of varicose veins hinges upon a thorough ultrasound examination of your veins. This exam provides a detailed map of your veins, including veins that can’t be appreciated by visual examination. More importantly, this exam identifies valve dysfunction (reflux), the root cause of varicose vein formation. Ultrasound also identifies the presence of clot. This exam is performed in our office by our registered vascular technologist (RVT) and is interpreted by Dr. Nachbauer, RPVI (Registered Physician in Vascular Interpretation). The exam takes a little over an hour for both legs and will be covered by your insurance.

Compression Therapy

Compression stockings are the first line of therapy for symptomatic varicose veins. They should be applied early each morning, worn throughout the day, and removed before retiring. They are designed to improve the function of the poorly-functioning valves and thereby improve the return of blood back to the heart.

We will measure your legs to determine your proper size and instruct you in donning techniques. If you do not have compression hose, we carry Sigvaris® medical grade compression hose for your convenience.


Thermal: Radiofrequency : ClosureFast™

Radiofrequency ablation involves closing the insufficient vein using a heating element at the end of a catheter. This technique is effective, safe, well tolerated and has replaced the decades-old practice of vein stripping. Radiofrequency ablation is done in our offices using local anesthesia and mild sedation, eliminating the need for a hospital visit or general anesthesia. Recovery is usually prompt, without need for pain medications. Physical limitations following the procedure are minimal. Radiofrequency ablation is usually covered by most insurance plans.


This is a new procedure that accomplishes the same result as radiofrequency ablation. Instead of closing the diseased insufficient vein with heat, VenaSeal™ and Varithena™ accomplish this in a very similar manner but with several advantages:


  • Very little local anesthesia is required.
  • More of the lower leg can be treated because these are non-thermal techniques.
  • VenaSeal™ uses a bio-glue and Varithena™ uses a microfoam.
  • After VenaSeal™ there is no need for compression therapy.
  • Varithena™ allows for a more non-invasive treatment of tortuous tributaries.


Used for treatment of branch varicose veins that cannot be treated by radiofrequency ablation or VenaSeal™, microphlebectomy is the surgical removal of enlarged veins using several very small punctures no greater than 1-2 mm in length. Like radiofrequency ablation and VenaSeal™, microphlebectomy can be safely and comfortably performed in our office, using local anesthesia and mild sedation. Recovery is typically prompt and uneventful. Microphlebectomy is typically covered by most insurance plans.


Sclerotherapy involves injecting a chemical into superficial veins causing the veins to close and, thereby, disappear. It is safe, effective and well-tolerated.


  • Liquid Sclerotherapy is used to treat smaller sized veins. The chemical is called polidocanol, or Asclera®, and has been in use for many years. It is a safe, dilute “detergent sclerosant”: a medical soapy chemical that gently encourages the body to remove the unwanted veins.
  • Foam sclerotherapy may be used to treat larger veins. The same soapy chemical is agitated with air to produce a foam, allowing these larger veins to be treated effectively without having to increase the concentration of the sclerosant.
  • Ultrasound-guided Foam Sclerotherapy uses ultrasound to inject veins that are too deep to be seen from the surface. This is sometimes covered by insurance.

Free Vein Screening

  • North Country Thoracic and Vascular is now hosting free vein screenings. This is an opportunity for you to talk with vein specialists about your varicose and spider veins.
  • You will learn about the cause of vein problems and how they are diagnosed.
  • You will also learn that varicose veins are not solely a cosmetic concern but are frequently associated with a number of symptoms including aching, throbbing leg pain, heaviness and fatigue, and restless legs.
  • You will learn that the most advanced form of vein disease includes swelling and damage to the overlying skin causing skin breakdown and ulceration.
  • You will also learn how these problems are manageable with the minimally-invasive office procedures currently available.
  • During the screening, you will be asked some basic health questions to help determine your risk for venous disease. Your legs will be examined, so bring a pair of shorts.
  • To attend an upcoming vein screening, call us at 518-314-1520 or 802-652-1520.

Call Us to Schedule a FREE Consultation