Established in 1992, the Vein Center of Louisiana was the first clinic in the state dedicated to the comprehensive diagnosis and treatment of varicose veins and spider veins. Although Dr. Ingram had practiced vascularsurgery since 1979, new advances in thetreatment of venousdisease developed inEurope prompted him to study them andbeamong the first in this country to offer theseservices here. In 1992, he was the first in Louisiana to perform the Ambulatory Phlebectomyprocedure for varicose veins using the sutureless European microsurgery technique. In 2001, Dr. Ingram was the first in Louisiana to perform the Endovenous Ablation procedures for varicose veins, both the RF Closure device and the Laser. The Vein Center of Louisiana has also been on the cutting edge in the cosmetic treatment of unattractive spider veins using both the latest technology (laser) and the latest techniques (foam sclerotherapy) as well as traditional sclerotherapy.

Many physicians from around the country have visited the Vein Center to learn various techniques from Dr. Ingram, including specialists in the fields of plastic surgery, heart surgery, vascular surgery, dermatology, general surgery, anesthesiology and OB-Gyn.

Dr. James Ingram is a graduate of the United States Air Force Academy, where he received his Bachelor of Science degree in 1964. He attended Louisiana State University School of Medicine in New Orleans and did his internship at St. Joseph Hospital in Denver. Dr. Ingram completed the LSU general surgery residency at Charity Hospital in New Orleans in 1974 and became board certified in general surgery. After serving four years on active duty as an Air Force surgeon he furthered his education by performing a fellowship in vascular surgery at the University of South Alabama, Mobile, finishing in 1979. He subsequently became board certified in vascular surgery. He also later achieved certification as a Registered Vascular Technologist/Ultrasonographer. When the American Board of Phlebology first established formal board certification in this new specialty of venous disease, Dr. Ingram was among the initial group of physicians to pass the board examination and attain certification. He was one of only three in the state of Louisiana to become a Board Certified Phlebologist.

Dr. Ingram retired as a full Colonel in the U.S. Air Force Reserve. His last assignment was Commander of the 433d Contingency Hospital at Lackland AFB, San Antonio, Texas.

He is a member of the following professional associations:

• Surgical Association of Louisiana (President, 1998-99)
• Gulf Coast Vascular Society (Advisory Board, 1988-96)
• Cohn-Rives Surgical Society, LSU (President, 2005-06)
• American College of Surgeons
• Society for Vascular Surgery
• American College of Phlebology
• Peripheral Vascular Surgery Society
• Louisiana State Medical Society
• Lafayette Parish Medical Society
• Society for Vascular Ultrasound

Dr. Ingram is a Clinical Assistant Professor in the Department of Surgery at the LSU School of Medicine, and has served as chairman of the surgery department at Lafayette General Medical Center. He has appointments on the staffs of the following hospitals:

• Our Lady of Lourdes Regional Medical Center, Lafayette
• Lafayette General Medical Center, Lafayette
• Park Place Surgery Center Hospital, Lafayette

Dr. Ingram is active in the local community, having served on the Lafayette Regional Airport Commission, on which he served as chairman in 1994. He has also served on the Board of Trustees for the Louisiana Health System Corporation (Lafayette General Medical Center), and has been a member of Leadership Lafayette. He is a past member of the Board of Directors for the Emergency Medical Services Council of Acadiana.

EndoVenous Laser Ablation/Cage

This revolutionary new treatment for large varicose veins was pioneered at Cornell University in New York. Originally performed in Spain, the EndoVenous Laser Ablation is performed in the office, takes less than an hour and accomplishes the same thing as a major surgical vein stripping. Using ultrasound guidance and local anesthesia, a thin laser fiber in a catheter is threaded up the vein. As the catheter is slowly withdrawn, the laser shrinks and seals the large vein that causes varicose veins in most patients. There is little or no visible scarring. In those patients who are candidates for the procedure, it is 97% successful. It is virtually painless and there is little "down time." Recovery involves resuming normal daily activities the next day and wearing a support stocking for about a week. Strenuous exercise may be resumed in two weeks.

Cool Touch Laser

The CoolTouch 1320 nm wavelength laser is our most recent acquisition and our current first choice for EndoVenous Laser Ablation procedures. The gentle manner in which this laser operates minimizes post-procedure discomfort while still offering 97% effectiveness.

VNUS RadioFrequency Closure

Similar to the EndoVenous Laser Ablation, a special catheter is passed up the major vein feeding the varicose veins. The vein is sealed shut using radiofrequency energy. Recovery following the procedure is the same as for the laser ablation.

Ambulatory Phlebectomy

This is another innovation first introduced in Louisiana by Dr. Ingram in 1992, and which remains the gold standard for cosmetic surgical removal of varicose veins. Commonly spoken of as the European microsurgery technique, the ambulatory phlebectomy procedure involves removing varicose veins surgically through incisions so small that sutures are not needed, post-op discomfort is minimal and scars are usually not even visible. The concept is quite simple and was developed by a Swiss dermatologist. Varicose veins can be likened to balloons: when they are inflated they are large, but when deflated they are quite thin walled and small. Have you ever noticed what happens to your veins when you lie down and elevate your legs? They empty and collapse, just like balloons. Thus, using a special technique and small instruments, large veins can be removed through tiny incisions. Dr. Ingram usually uses a hypodermic needle, rather than a scalpel, to make the little nicks in the skin.

Ambulatory phlebectomy, as the name suggests, is always an outpatient procedure which can be done in the office under local anesthesia if the extent of the condition is not too great. In severe cases patients are more comfortable asleep. Regardless, they are encouraged to walk a mile the next morning and resume normal activities except for strenuous exercise (like aerobics) for a week or two. A firm support stocking is worn during the day for about ten days.

Minimally Invasive Vein Stripping

In spite of all the technological advances in vein treatments there are still occasional cases in which the most appropriate treatment is surgical stripping. Fortunately, about ten years ago a brilliant Swiss vascular surgeon named Andreas Oesch developed the PIN stripper. This device allows large veins to be stripped through much smaller incisions and much less traumatically than conventional techniques. Dr. Ingram mastered this method shortly after it became available and used it routinely until the endovenous devices eliminated the need for most vein strippings. It remains among the Vein Center's many options for patients who need it.

Sclerotherapy

Sclerotherapy is the oldest treatment method of abnormal veins and remains one of the mainstays of eliminating spider veins and certain varicose veins. A tiny needle is used to inject a gentle solution into the involved vein, causing it to close down and be absorbed by the body. There is little discomfort with the procedure. Elastic compression hose are worn after each treatment. The duration depends upon the size of the vessels and may vary from two days to two weeks. Several treatments are usually required. There are three general types of sclerotherapy in current practice in modern phlebology:

1. Traditional Sclerotherapy
in which an appropriate concentration of an appropriate solution (there are several) is injected into the abnormal vein under direct vision, frequently using magnification.

2. Ultrasound Guided Sclerotherapy
in which larger (and usually deeper) varicose veins or their feeding veins are injected using a duplex scanner to guide the needle.

3. Foam Sclerotherapy
in which the sclerosing solution is actually injected as a foam rather than as a liquid. This is the latest and most modern technique. It is more effective and requires fewer needle sticks than traditional methods. It can be used with both direct injection and ultrasound guided approaches.

Dornier Diode Laser

This cutting-edge technology is effective in treating thee two extremes of vein sizes, the very large varicose veins and the smallest spider veins. The 940 nm wavelength Diode Laser is a device used for EndoVenous Laser Ablation and is also effective in coagulating and destroying small spider veins directly through the skin. It is frequently used in conjunction with sclerotherapy for doubly effective treatments and quicker results.

Endoscopic Perforator Surgery

Chronic Venous Insufficiency, a disabling swollen leg condition often associated with ankle ulceration, can now sometimes be greatly improved by a minimally invasive operation performed through a scope. The procedure is called Endoscopic Subfascial Perforator Surgery. It is performed on an outpatient basis through one or two small incisions in the upper calf.

Nd-YAG Laser

The Neodynium YAG Laser with a 1064 nm wavelength is proving to be extremely effective in the treatment of both reticular veins of the legs and large spider veins of the face, especially on the nose. Its longer wavelength penetrates deeper and is less absorbed by skin pigment than most other lasers. This makes it safer to use on darker skinned individuals.

"FotoFacial" Intense Pulsed Light

Intense Pulsed Light technology has emerged over the past few years as nothing short of revolutionary in the treatment of Rosacea. This non-laser application of short duration, momentary exposure of the skin to high intensity flashes of light shrinks and destroys the tiny dilated capillaries that cause the blushed appearance of this condition. Another beneficial effect is the removal of lentigines (age spots, sunspots) and other unwanted areas of unsightly pigmentation. There is also a skin smoothing and pore shrinking effect. The overall result of a series of about five monthly treatments is called PHOTOREJUVENATION.