DR. MOHAMMAD ALTWALAH

1. Vein Clinic: What do We Need?
Mohammad Altwalah
Riyadh
Saudi Arabia

2. Impact on Health
> 50 million americans
30 % of women
15 % of men
not only cosmetic

3. Complications
Pain
Swelling
Thrombophlebitis
Hyperpigemtion
eczema
bleeding
ulcer

4. Classification
CEAP
Clinical Etiologic Anatomic Pathophysiologic
C0: No visible or palpable signs of venous disease
C1: telangiectases or reticular veins
C2: varicose veins
C3: edema
C4: skin changes ascribed to venous disease
a. pigmentation or eczema
b. lipodermatosclerosis or atrophie blanche
C5: healed ulcer
C6: active ulcer

5. Pathiophysiology
Reflux

6. Anatmoy

7. Treatment
Eliminate reflux

8. Be the local expert
 Knowledge of superficial venous anatomy
 Knowledge of pathology patterns
 Answer all questions
 Explain what to expect

9. How to start

10. Clinic decisions
 In hospital ( no costs but limiting)
 Separate clinic ( cost $$$) but can add other services

11. Ultrasound Doppler is
needed

12. Sclerotherapy
quick
safe
effective

13. Sclerotherapy agents

14. Foam scleroherapy
> potency
? TIA

15. Microsclerotherapy

16. Magnification glasses

17. ULTRASOUNDED GUIDED

18. Mini phlebectomy

19. Treat it all

20. Veinlite

21. Endovenous laser or RF

23. Brochure
Bye bye varicose veins

24. Website

26. Media & Youtube

27. Be the local expert

28. How to run a clinic
 Get a good clinic manager
 Marketing team
 Insurance coverage…. A must

29. Conclusions
 Varicose veins are a large health problem
 IR is the best doctor who can treat them
 Vein clinic are successful…. Need time & effort