Established in August 2003, VeinSolutions brings together a group of experienced and specialized board-certified surgeons dedicated to using the latest technologies in the diagnosis and treatment of varicose veins and spider veins of the legs and face. The concept is simple - to combine aesthetics and medicine in the comprehensive care of cosmetic and therapeutic vein problems.
VeinSolutions is a division of Cardiothoracic and Vascular Surgeons (CTVS), a leading surgical group serving Central Texas for over 50 years. CTVS provides state-of-the-art diagnostic services and surgical procedures on the heart, lungs, chest, and major blood vessels. A team of 20 board-certified cardiothoracic and vascular surgeons care for patients of all ages from San Angelo to the central and area offices and in Austin. Our surgeons have privileges at all area hospitals. The CTVS goal is to provide patients with the finest in medical care and to restore them as quickly as possible to good health.
Emery W. Dilling, M.D.
Dr. Dilling is originally from Fletcher, Oklahoma. He received his medical degree from the University of Oklahoma where he also completed an internship and two residencies. He completed a fellowship at the Veterans’ Administration Hospital followed by General Surgery and Thoracic Surgery residencies at the University of Oklahoma Health Sciences Center where he served as chief resident of surgery. He has practiced with Cardiothoracic and Vascular Surgeons since 1980. He is a Fellow of the American Heart Association and a Diplomate of the American Board of Thoracic Surgery.
Dr. Dilling formerly specialized in adult Cardiothoracic Surgery including heart transplantation, coronary bypass surgery, valve repair and replacement, minimally invasive surgery, and off-pump coronary bypass surgery, and now specializes in minimally invasive treatment of varicose veins, including laser and sclerotherapy.
Dr. Dilling has been appointed to various leadership positions including President of the local chapter of the American Heart Association. He is also an active member of the Texas Medical Association, Travis County Medical Society, and the Southern Thoracic Surgical Association. Dr. Dilling has participated in numerous research studies and has authored many research articles in his specialty. Dr. Dilling is a member of the Vein Therapy News Editorial Advisory Board.
Jeffrey M. Apple, M.D., F.A.C.S.
Dr. Jeff Apple is originally from Dallas, TX. He completed medical school at the University of Texas Health Science Center in San Antonio and his general surgery residency at the University of Texas Southwestern Medical Center. Dr. Apple then served four years in the United States Navy where he served as a staff surgeon at the Naval Medical Center San Diego. During his time in the Navy he was deployed twice to the Persian Gulf in support of Operation Iraqi Freedom.
He completed his vascular surgery fellowship at Baylor University Medical Center in Dallas, TX. He is an active member of the Society of Vascular Surgery, Alpha Omega Alpha, the Society for Vascular Ultrasound and Parkland Surgical Society. He is a Fellow of the American College of Surgeons.
He has received numerous teaching awards and published several papers in the field of vascular surgery. His special interests include the endovascular treatment of thoracic and abdominal aortic aneurysms, the treatment of varicose vein disease and catheter-based procedures for arterial disease. Prior to joining CTVS, Dr. Apple practiced with Jackson Surgical Associates in Jackson, TN.
Medical Treatments
- Free Venous Screening Exam
- State of the Art Diagnostic Testing
- Laser / Light Therapy
- Sclerotherapy
- Endovenous Laser Ablation (EVLT)
- Minimally Invasive Vein Surgery (MIVA)
- Radiofrequency VNUS Closure
Other Services
- Patient Education
- Insurance Documentation Filed on Behalf of Patient for Medically Necessary Diagnosis and Treatment
- Treatment Estimates
Venous Duplex Imaging
Duplex scanning of veins utilizes ultrasound to visualize a vein to determine the exact anatomy, direction of blood flow within a vein and to assess for abnormal valves. With this improved ultrasound technology the physician is better able to diagnose underlying problems and prescribe a treatment plan tailored to a patient’s individual needs. This is important to achieve the best long-term cosmetic and therapeutic results. The registered vascular technologists have been specifically trained by our vascular surgeons. The test is non-invasive, no preparation is needed and it takes approximately 30 to 60 minutes to complete. Venous duplex scanning is typically a covered expense by most insurance companies.
Sclerotherapy
Sclerotherapy is an injection treatment used to eliminate "spider" veins and small to medium-size varicose veins. A solution is injected into the problem vein with a very fine needle. The vein wall becomes irritated. Subsequent application of external compression with dressings and prescription-gradient compression hose seals the vein wall together. The body breaks down the damaged vein and absorbs it, ultimately eliminating the problem vein. No pre-treatment patient preparation is needed and most patients describe minimal discomfort. After treatment patients resume normal activities, but are asked to avoid prolonged sitting and standing for 3 days and heavy exercise (weight lifting, running and high impact aerobics) for two weeks. Walking is encouraged after the treatments. Prescription-gradient compression hose are worn for 9 days after each treatment.
Laser / Light Therapy
VeinSolutions currently utilizes laser/light therapy source. Laser light sources are the latest technologies in the treatment of "spider" veins, of the face trunk and legs. This improved technology is effective in eliminating problem vascular lesions without damaging the surrounding skin. Laser/light therapy is most effective when treating people with a "fair" complexion. Successful treatment of facial lesions may be accomplished with as little as one treatment but usually requires two to three treatments. Leg veins usually require multiple treatments. The treatment is tolerated by most people with minimal discomfort. Moderate to significant redness and swelling of the area treated is expected and usually resolves in 3 to 10 days depending on the amount of swelling and redness. Patient preparation requires the area being treated without sun exposure or the use of sunless tanning products for four weeks before and after each treatment. Make-up may be applied after facial redness and swelling has subsides. Prescription-gradient compression hose may be necessary for 48 hours after treatment of leg veins.
Endovenous Laser Ablation (EVLT)
The endovenous laser procedure (EVLT or ELVeS) is a non-surgical, minimally invasive treatment option for varicose veins. It may be done in the office using local anesthesia. A small catheter is inserted into the problem vein via a puncture near the knee. Using the catheter, a fiber is threaded to the upper end of the vein. As the fiber is withdrawn, it emits laser energy to close off the vein. Compression hose are worn for several days after the laser treatment. There is minimal discomfort with endovenous laser treatments, and patients resume normal activities within a few days. Excellent long-term results, with only one treatment, can make the endovenous laser treatment an attractive choice for the treatment of your varicose veins.
Radiofrequency VNUS Closure
VeinSolutions currently utilizes the Radiofrequency VNUS Closure procedure. The VNUS Closure procedure is a minimally invasive treatment alternative for patients with a condition known as superficial venous reflux, which often results in varicose veins and other painful symptoms. Approximately 25 million people suffer from venous reflux. It is an alternative treatment option to traditional vein stripping surgery. The Closure procedure is an outpatient treatment performed in the outpatient department of the hospital or clinic. Local, regional, or general anesthesia may be used during the procedure. A thin catheter is inserted into the vein through a small opening, using only a single needle stick. The catheter delivers radiofrequency (RF) energy to the vein wall, causing it to heat, collapse and seal shut. Once the diseased vein is closed, other healthy veins take over and empty blood from the legs. As normal return flow is re-established, your symptoms should improve noticeably. Following the procedure, the catheter is removed, a compression bandage is placed over the insertion site and your leg to aid healing.
Minimally Invasive Treatment (MIVA)
Minimally invasive vein surgery is the treatment of choice for larger varicose veins to achieve both the desired cosmetic results and to relieve symptoms such as aching, swelling and pain caused by leg varicosities. Our vascular surgeons are experienced and skilled with venous anatomy and strive to constantly update their surgical expertise. Today's surgical techniques for varicose veins require minimal incisions and are performed on an outpatient basis with average recovery time of one week or less. Meticulous effort is made to achieve optimal cosmetic and therapeutic results.
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