Welcome to the Vein Disorders Center Website

Welcome to Vein Disorders Center (VDC) website created to educate potential patients interested in therapeutic services available today for an array of vein problems performable in an office setting and, when necessary, in strictly local anesthesia. The VDC is equipped to handle diagnostic as well therapeutic modalities only in an ambulant fashion; downtime and convalescence will never  be necessary. We realize that nowadays a potential patient with vein problems has many setups to chose from so...

+6

VEIN DISORDERS CENTER

16311 Ventura Boulevard
Suite 1255
Encino, CA 91436
Phone: (818) 905-5502
Email: drgoren@gorenveincenter.com

 

Why Choose VDC?

 

First and foremost because Dr. Goren is a SURGEON by specialty and venous pathology was a studied subject imbedded in his 6 years of surgical residency. It is unfortunate that nowadays most "vein specialists" (phlebologists) are internists, interventional cardiologists or interventional radiologists, gynecologists, family practitioners, or emergency medicine specialists, some totally limited in background knowledge and surgical skills who chose the field for purely financial gains. Indeed, some if not most venous treatments are not recognized as a medical necessity, and insurance reimbursement for cosmetic conditions does not exist; thus, some venous treatments are cash business and the sky's the limit...True too, the newer high tech therapeutic modalities such as endovenous thermal ablation for varicose veins - should the procedure be recognized by the insurance companies as medically necessary - is much better reimbursed when compared to the minimally invasive in-office Ambulatory Phlebectomy, procedure, that in my humble opinion, is a far superior therapeutic modality when results and potential complication are juxtaposed.* Being financially attractive,  the two high tech modalities are frequently abused and performed unnecessarily while needlessly submitting patients to an array of severe thromboembolic complications such as deep vein thrombosis (DVT) and the potentially lethal pulmonary emboli (PE). These dreaded complications were never observed in well over 4000 minimally invasive ambulatory phlebectomy procedures performed by Dr. Goren in an office setting using local anesthesia forgoing downtime, convalescence, and loss of income.

 

* In 2009 I was the last time targetted by a company manufacturing the hardware necessary for a thermal ablation procedure. The representative put on my desk a document detailing the Medicare National Payment Rates for that year.

The procedure performed by the peddled hardware with the CPT code 36457, was reimbursed by $ 2,493. The surgical procedure for the same varicose veins condition, CPT codes 27722, only a meager $465.

What is, however, UNBELIEVABLE is that an open repair for an Aortic Abdominal Aneurysm (a very high mortality condition) CPT code 34830, the reimbursement was $ 1,858! A lower reimbursement compared to the varicose veins procedure.

No wonder that doctors ( from different specialties) turned overnight vein specialists. The problem is that the procedure is overused in just pure cosmetic conditions such as spider veins. This is a shame. Not to speak that ablating the saphenous vein with the thermal method, kills the most important spare part cardiac and vascular surgeons need when coronary or peripheral bypass procedures are demanded to save lives.

The second reason to choose VDC is EXPERIENCE. After exactly twenty years of University-based academic surgical career in Israel and in the US, Dr. Goren opened his private office in Encino, CA - a suburb of LA - in 1984. This year (2020) he celebrated an unparalleled 36 years of an exclusive in-office VEIN practice. Moreover, the total (over 40000) surgically treated varicose legs using the minimally invasive approach (Ambulatory Phlebectomy) in his setup since the early nineties, surpasses the seating capacities of several main concert halls of this country such as NY's Carnegie Hall’s (2804), Lincoln Center’s Avery Fisher Hall (2739), LA's Dorothy Chandler Pavilion’s (3194) as well as the Disney Hall (2265).

Thirdly, contrary to many other veins specialists Dr. Goren is a PUBLISHED author including in  peer-reviewed professional journals. He has above 30 overall surgical career publications (see in my CV next page) out of which over 20 are in the venous field. His 1991 article, published in Am J Surg, (vol. 162, pages 166-74) on the minimally invasive Ambulatory Phlebectomy surgical approach for varicose veins is the first of its kind in the American surgical literature. Indeed,  Dr. Goren is the first to introduce this Swiss method to the American surgical establishment. (Click here to see this referenced in The Vein Book)  His comprehensive and fully illustrated invitational technical article on the subject saw print in 1995 in the Ann of Vasc Surg. (vol. 20, pages 401-14) and was also translated in French as well as in Spanish.

Please note that consultation is complimentary during which Dr. Goren will discuss all your needs and desires related to your unwanted spider, reticular and varicose veins wherever they may be located on the body: legs, chest/breast, face, temple, forehead or hands. Rest assured, we are committed to the excellence of care and your TOTAL satisfaction. Turning you into a well-informed consumer and at the same time into an ambassador of our practice is our ultimate goal.  Please consult what other patients have said about us:

 

https://www.healthgrades.com/physician/dr-gabriel-goren-wh39g

 

https://www.yelp.com/biz/goren-gabriel-md-encino?start=20

© 2016 VEIN DISORDERS CENTER. ALL RIGHTS RESERVED. | DISCLAIMERS

 

What do I do for a skin injury received after Sclerotherapy?

 

            I have seen skin injuries after sclerotherapy but usually, very small ones 2-3 mm in diameter but larger than that should not happen! I do not know what size vein(s) have been injected and where the ”skin burn” is localized, hope not in the ankle area where the healing will be much slower. You must have been possibly injected with a too high concentration and the high volume of the sclerosing agent and also possibly not injected properly into the vein but rater in the skin and tissues along the vein! Occasionally, there are open communications between veins and arteries and the possibility does exist that the sclerosing agent while properly injected in the vein crossed into a small artery and caused severe tissue damage (necrosis) responsible for the damage and thus skin ulceration.

Unfortunately, there is not much one can do as eventually all will heal but it will take a few months. Most probably a scar for life will remind you of the “experience”.

            The injured area should be kept clean and covered with dry gauze to prevent any possibility of infection. If the area is by now clean namely not infected one should discuss with the practitioner the possibility of applying a colloid dressing called Duoderm. Compression stocking the knee is mandatory to prevent swelling which is the biggest enemy of any wound healing. Whenever just possible one should elevate the leg about the level of the heart; this should also reduce swelling by gravitational drainage. Any creams you may want to apply should never cover the ulcerated skin, just beyond its margins. In conclusion, be patient, it will go away but very slowly. How it is in Spanish: “Con paciencia se gana il cielo” or “Heaven is won with patience."