At Triangle Interventional Services, you will receive the attentive and superb personal care you expect.  Our experienced, well-trained medical staff is there to provide you with the knowledge and expertise you expect to make the right decisions, and will also help guide and support you throughout the procedure.  Our state of the art facilities will provide you with a safe, convenient, and comfortable environment.

All procedures are performed in our state-of-the-art outpatient Interventional Radiology facility, conveniently located on Weston Parkway, just off Harrison Boulevard and close to the airport. Our compassionate and efficient staff will make you feel safe and welcome.

Stephen P. Loehr, MD

Dr. Loehr is Medical Director, at Regional Vascular Associates and Triangle Interventional Services.  He is known for his patients care and cosmetic vein treatments. He is a Durham native that now lives in Durham with his wife and beautiful daughter.

Medical School: Wake Forest University (Bowman Gray School of Medicine).
Residency: Diagnostic Radiology, Mallinkrodt Institute of Radiology and Wake Forest University School of Medicine.
Fellowship: Vascular and Interventional Radiology, Alexandria Hospital.
Board Certification: American Board of Radiology with Certificate of Added Qualification in Vascular and Interventional Radiology.

J. Robert Yankes, MD

Dr. Yankes  is Division chief of interventional radiology and former Medical Staff President at Durham Regional Hospital. Dr. Yankes has lived and practiced in the Triangle since 1983. He is married with two young adult daughters. He enjoys the outdoors, the beach, and golf.

Medical School: University of Pittsburgh School of Medicine.
Internship: Transitional, Mercy Hospital of Pittsburgh.
Residency: Diagnostic Radiology, Duke University Medical Center.
Fellowship: Vascular and Interventional Radiology, Duke University Medical Center.
Board Certification: American Board of Radiology with Certificate of Added Qualification in Vascular/Interventional Radiology.

PROCEDURES & SERVICES

Interventional Radiology:  Nonsurgical Outpatient Procedure  Treats Varicose Veins

Venous insufficiency is a very common condition resulting from pooling of blood within leg veins due to poorly functioning vein valves. Normally, one-way valves in the veins keep blood flowing toward the heart.  When standing, the valves close. With exercise, the muscles of the thigh and calf contract, forcing the blood through the valves against the force of gravity.  When the valves become incompetent, they don't close properly.  This allows blood to flow in reverse, a condition called venous reflux. When venous reflux is present, there is increased hydrostatic pressure within the vein causing it to become dilated and varicose.

• Approximately half of the U.S. population has venous disease--50 to 55% of women and 40 to 45% of men. Of these, 20 to 25% of the women and 10 to 15% of men will have visible varicose veins.
• Varicose veins affect 1 out of 2 people age 50 and older, and 15 to 25% of all adults.

Symptoms

Symptoms caused by venous insufficiency and varicose veins include leg aching, pain, and heaviness. These symptoms tend to be worse by the end of the day and are relieved by rest and elevating the legs. With advanced venous insufficiency, open wounds may develop.  These are called venous stasis ulcers.

People without visible varicose veins can still have symptoms. The symptoms can arise from spider veins as well as from varicose veins, because, in both cases, the symptoms are caused by pressure on nerves by dilated veins.

Diagnosis

An ultrasound examination can assess the valves within the leg veins.  A vein map is developed labeling the good veins from the ones with leaky valves.  Treatment is then targeted at the veins with the faulty valves.

Vein Ablation Treatment

This minimally-invasive treatment is an outpatient procedure performed using ultrasound guidance. After numbing the vein with local anesthetic, a thin fiber is inserted within the vein using ultrasound guidance.  Laser of radiofrequency energy is delivered to the fiber which generates heat.  This heat cauterizes the vein and seals the vein closed.

By sealing the vein with the leaky valves, the varicose veins, which are close to the skin, shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.

Benefits of Vein Ablation Treatment

• The outpatient treatment takes less than an hour and provides immediate relief of symptoms.
• Minimally invasive alternative to surgical “vein stripping”
• Immediate return to normal activity with little or no pain. There may be minor soreness or bruising, which can be treated with over-the-counter pain relievers.
• No scars or stitches - because the procedure does not require a surgical incision, just a nick in the skin, about the size of a pencil tip.
• High success rate and low recurrence rate compared to surgery.
• The success rate ranges for vein ablation ranges from 93 - 95 percent.

Insurance

Many insurance carriers cover the vein ablation treatment, based on medical necessity for symptom relief.

Injection & Laser Sclerotherapy

Can also be used to treat some varicose and nearly all spider veins. An extremely fine needle is used to inject the vein with a solution which shrinks the vein.

Laser Sclerotherapy

Cosmetic laser sclerotherapy performed for spider telangiectasis and reticular veins using the Lyra Laser System. Patient evaluation and consolation services are performed at our office.

Ultrasound-guided Sclerotherapy

Involves an interventional radiologist passing a thin tube called a catheter into the vein using ultrasound guidance and injecting substance that causes the veins to scar and close - rerouting the blood to healthier veins. The affected vein forms a knot of scar tissue that is absorbed by the body over time.

Handsclerotherapy

Over the years, we lose fatty tissue and elasticity in the hands resulting in prominent veins which appear much larger. With a minimally invasive procedure the Vein Center at TIS can create a dramatic effect to the appearance of hands. Handsclerotherapy involves a series of precise injections and entails 2 to 3 sessions of sclerotherapy. Each session is virtually painless and takes less than thirty minutes. With microphlebectomy, a local anesthetic is injected over the bulging veins and very small skin nicks are made over the veins. Using special instruments the unsightly veins are gently removed. No stitches are necessary and there is minimal downtime from normal activities. The results have been very positive for both male and female patients.
 
Microphlebectomy

A minimally invasive surgical technique used to treat varicose veins that are not caused by saphenous vein reflux. The abnormal vein is removed through a tiny incision or incisions using a special set of tools. The procedure is done under local anesthesia, and typically takes under an hour. Recovery is rapid, and most patients do not need to interrupt regular activity after microphlebectomy.