The Rhode Island Vascular Institute (RIVI) is an outpatient medical office as well as a licensed, accredited physician ambulatory surgical center  located at 690 Eddy Street in Providence, Rhode Island.  RIVI is a division of Rhode Island Medical Imaging (RIMI).  RIMI  is one of the largest and oldest radiology groups on the east coast, founded in 1943. We are diagonally across the street, footsteps from the Rhode Island Hospital campus.

We provide free, convenient parking and wheel chair access at our state of the art, modern facility.

We are staffed by 10 board certified vascular interventional radiologists who also perform procedures at Rhode Island Hospital, Miriam Hospital, Newport Hospital, Hasbro Childrens Hospital, and Women & Infants Hospital. Our physicians include the Chiefs of Vascular and Neuro Interventional Radiology as well as the Fellowship Director of Interventional Radiology at Rhode Island Hospital. All physicians enjoy academic faculty appointments at the Warrren Alpert School of Medicine of Brown University and many are nationally recognized in their field. 

In order to provide the safest, least stressful experience, we are fully staffed by Physician Assistants, Registered Nurses, certified radiographers, vascular ultrasonographers,  and certified medical assistants. Our knowledgeable and experienced secretaries and receptionists are ready to help welcome you to RIVI! Our fulltime, expert certified clinical practice & site manager is eager to guide you through your experience and help you and your loved ones in anyway possible.

Varicose Veins

Do you suffer from the discomfort of unsightly varicose veins?
Are your legs heavy, swollen and in pain by the end of the day?
Do you keep your legs covered at all times due to disfiguring varicose veins?
Have you researched the standard treatment of surgical stripping, but do not want to endure this painful procedure?

Now there is an alternative offered at Rhode Island Vascular Institute, a virtually painless and simple procedure performed by board certified physicians called endovenous laser ablation.

Endovenous laser ablation is a progressive alternative to surgical ligation and stripping. Surgical ligation and stripping is performed under general anesthesia and involves at least two surgical incisions in order to tie off and pull out the faulty vein. With endovenous laser ablation there is no anesthesia involved and there is a lower recurrence rate, shorter recovery period, lower costs and no scarring as compared with other procedures.

FAQs
How does the procedure work?
The laser beam targets the vein walls, shrinking them and thus closing the faulty vein so that the blood can no longer flow through it. The laser beam energy is from an 810 nm diode laser delivered by a fine fiber-optic probe. As it is only the probe and a slim sheath which need to enter the vein the whole procedure is performed via a tiny skin nick, so there will be no post-operative scarring. The probe is guided into place using ultrasound and the procedure is performed under strictly local anesthetic of a similar type used by dentist to numb the treatment area.

Is the loss of this vein a problem?
No. There are many veins in the leg and after the treatment, the blood in the faulty veins will be diverted to the normal veins and eventually back to the heart.

What complications are associated with this procedure?
There are potential complications with any medical procedure. The only minimal complication yet experienced with the endovenous laser ablation procedure has been a small number of cases of temporary (numbness.

Is there any risk from the laser?
No. However, as a precaution, you will wear a pair of special eye glasses during the procedure.

Are there alternative treatments available?
Yes. The two most common procedures are ultrasound guided sclerotherapy (injection therapy) and radio frequency electrosurgery. Injection therapy for the saphenous vein appears to have a high recurrence rate frequently requiring retreatment. However, it is excellent for cosmetic treatment of any visible veins remaining after endovenous laser ablation. This procedure is also performed at our Vein Center after endovenous laser ablation or as a stand-alone treatment for those with only smaller varicose or spider veins.

How successful is endovenous laser ablation?
Results have been extremely favorable with success rates as high as the more painful and invasive approach of surgical ligation and stripping. Endovenous laser ablation will normally treat the cause of most varicose veins but additional/complimentary therapy (such as the sclerotherapy mentioned in the previous paragraph) may be necessary in some cases.

What is the first step towards smoother less painful legs?
Schedule a consultation with a board certified specialist at Rhode Island Medical Imaging. The patient and physician can decide together if this procedure is appropriate.

What causes varicose veins?
Veins carry blood from the tissues eventually back to the heart. The thin walled veins can become squeezed by muscles as they contract thus forcing the blood into non-return valves. If the non-return valves become faulty and fail to close, the blood can run backwards (or reflux) and pool in the legs. If this extra blood is sitting in veins close to the surface of the skin, the veins will swell up and become visible and “varicosed”.

There is one major vein in the leg, the greater saphenous vein, which connects to many of the superficial surface veins. Failure of the valves in this vein is quite common and is a major cause of surface varicose veins. The saphenous vein runs down from the groin to the lower leg with varicose veins commonly occurring in the lower thigh, around the knee and in the calf.

Deep Venous Thrombosis

Over 600,000 new cases of deep venous thrombosis are diagnosed each year, with a mortality rate of 1%.  Blood clots can form in the deep veins of the arms, legs, and pelvis.  Clots are thought to form from any combination of stasis, hypercoagulable state, and vessel injury, known as Virchow’s Triad.  Risk factors for DVT include smoking, medications (birth control pills), immobility, long airplane or car trips, hypercoagulable state (e.g. cancer), and traumatic venous injury.  Symptoms of DVT include swelling, redness, and painful limb.  Complications of DVT include pulmonary embolism (PE) - i.e. when the clot travels to the pulmonary arteries.  Symptoms of PE include shortness of breath, chest pain, increased pulse rate, and bloody sputum.  PE can be fatal in some cases.

Post thrombophlebitic syndrome is an under recognized but more common side effect of DVT.  Blood clots can lead to vein and venous valve damage in as short as 8 weeks and can lead to abnormal blood pooling in the legs, known as PTPS.  Up to 69-70% of patients may suffer from this long- term sequelae.   Standard medical treatment of DVT is anticoagulation, which unfortunately does not actively dissolve clots but rather prevents additional clots from forming and allows the body to slowly dissolve the existing clot.  Symptoms of abnormal pooling are similar to varicose veins and include chronic leg fatigue, swelling, and in extreme cases venous ulceration.  Studies are now showing early and prompt removal of the clot via chemical and mechanical means can prevent post thrombophlebitic syndrome.