Treatment Programs

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Venous Disease Program

Physicians at the Venous Disease Program at the Massachusetts General Hospital Vascular Center use novel endovenous minimally invasive and endovascular surgical interventions, as well as lifestyle modification strategies to diagnose and treat patients with deep vein thrombosis (DVT), varicose veins and other venous disorders.

Our Approach Clinicians at the Vascular Center’s Venous Disease Program are leaders in the investigation and use of surgical and endovascular interventions to treat and prevent complications of deep vein thrombosis (DVT), the presence of a blood clot in the deep veins of the body. Our clinicians also use a number of minimally invasive approaches to treat varicose veins and other venous disorders without open surgery, resulting in faster recovery times.

A Multidisciplinary Approach to Vascular Care

The Mass General Vascular Center is one of the only vascular centers in the country with specialists represented in every area of vascular disease. The Venous Disease Program brings together a team of clinicians from multiple disciplines to provide care from many perspectives, including:

  • Vascular medicine and cardiology
  • Vascular and endovascular surgery
  • Vascular interventional radiology
  • Hematology
  • Wound care
  • Anticoagulation management service

We work together with the patient and referring physicians to coordinate personalized treatment plans for all patients.

Specialists Dedicated to Vascular Imaging

Our team is composed of full-time, board-certified specialists who are specially trained to detect abnormalities in the vascular system and whose practice focuses specifically on vascular disease. Each member of the team specializes in radiology, vascular medicine or vascular surgery, and is fellowship trained with additional expertise in vascular procedures.

Depending on the patient, we may use one or more techniques to diagnose venous disease, including:

  • Duplex ultrasound
  • CT scan
  • Magnetic resonance imaging (MRI)
  • Specialized blood tests
  • Venograms

These tests are available at the Mass General main campus or at the center’s convenient Waltham location.

The Latest Treatment Options for DVT

Our primary treatment goal is to prevent pulmonary embolism and post-thrombotic syndrome, a painful complication of DVT. We offer a number of medical, minimally invasive and surgical approaches, including:

  • Mechanical Thrombectomy. During this procedure, the clot is surgically removed or emulsified with the use of a specialized catheter from the vein. To prevent post-thrombotic syndrome, Mass General physicians are among the first in the nation to use the thrombectomy to treat patients within two weeks of a DVT, a new, proposed standard of care
  • Thrombolysis. In this minimally invasive technique, clot-dissolving medications are injected directly into the clot. Our physicians are currently investigating combining thrombectomy devices and thrombolytic medications to clear the vein of clot and hopefully prevent post-thrombotic syndrome
  • Anticoagulant Medications. People with DVT typically require treatment with anticoagulant medications such as heparin and warfarin to prevent clots from growing larger. Our specialists work together to carefully follow patients and adjust medications, as appropriate
  • Inferior vena cava filters. If a patient cannot take anticoagulant medications or it is not the optimal treatment, then a special filter may be placed in his or her vein to catch the clot if it breaks free. This also prevents pulmonary embolism, a life-threatening condition where the clot travels to the lungs

Minimally Invasive Treatments for Varicose Veins

Minimally invasive treatments generally offer patients shorter recovery times and smaller scars than traditional open surgical procedures. For patients with varicose veins, we specialize in a number of minimally invasive treatment options, including:

  • Sclerotherapy. In this technique, a chemical is injected into the affected veins to harden them so they can no longer fill with blood
  • Radiofrequency ablation (RFA). This therapy uses heat delivered through a catheter to treat varicose veins. Our physicians were among the first in Boston to perform an endovenous (via the veins) radiofrequency ablation
  • Endovenous laser therapy (EVLT). In this approach, lasers are used to treat affected veins in a similar manner to radiofrequency ablation (RFA)

Our physicians also fit patients with compression stockings, which squeeze varicose veins from flowing backward and offer support to the leg’s veins.

Taking Care of Chronic Wounds

Patients with vascular disease and poor circulation often experience chronic wounds that fail to heal or show delayed healing. Our wound care specialists provide expert, innovative care that promotes rapid healing and helps prevent and treat leg ulcers and other complications of venous disease.

About This Program The Venous Disease Program at the Massachusetts General Hospital Vascular Center offers the complete range of diagnostic, surgical and endovascular interventions to treat patients with deep vein thrombosis and varicose veins.

National Leaders in Our Field The Vascular Center has a long tradition of excellence in clinical care, and our clinicians are leaders in the diagnosis and treatment of DVT and varicose veins. Our distinguished staff is made up of many national figures in their respective fields. These physicians are at the forefront of new research and serve on national and international professional boards and societies.

Shaping Treatment through Research and Clinical Trials The Vascular Center participates in major clinical studies evaluating new technologies and devices to treat DVT and varicose veins. This allows us to bring our patients promising new treatments as quickly as possible.

Our clinicians are currently taking part in the ATTRACT trial, the first major national trial combining thrombolysis with thrombectomy to treat DVT supported by the National Institutes of Health. Several of our physicians participate as lead investigators for this trial and are members of its national steering committee.

Patients interested in participating in clinical trials can browse online for open trials.

Comprehensive Care for Difficult Cases Venous Disease Program physicians are skilled in treating complications from venous disease as well as less common conditions such as pelvic congestion syndrome, May-Thurner syndrome and Paget- Schröetter syndrome. Patients from across the country—and around the world—come to the Vascular Center because of our expertise in treating these and other rare venous disorders.

The breadth of resources at Mass General also allows us to address these complications with success:

  • Pulmonary embolism. DVT increases the risk of pulmonary embolism, a life-threatening condition in which the blood clot breaks off from the wall of the blood vessel and travels through the bloodstream to the lungs. Our physicians strive to prevent pulmonary embolism with interventions such as medications, inferior vena cava filters, thrombectomy and thrombolysis
  • Post-thrombotic syndrome. Some patients with DVT can develop symptoms such as swelling, pain and leg ulcers, even years after the clot formed. Our use of combination thrombolysis and thrombectomy shows promise for preventing this syndrome
  • Chronic DVT. At the Venous Disease Program, we offer hope for patients with chronic DVT through innovative treatment approaches such as thrombectomy, angioplasty and stenting. We also guide patients through lifestyle changes and connect them to our wound care specialists

One Call Coordinates Care

Our dedicated nurse coordinator is available Monday through Friday from 8:00 am to 5:00 pm to take relevant information about your condition and symptoms and to make a timely appointment with the most appropriate specialist.

We strive to see patients as soon as possible and assign every patient one clinician to organize care amongst members of our multidisciplinary team. From diagnosis to treatment and through follow up, this physician guides patients throughout the entire treatment process.

Conditions and DiseasesThe care team at the Vascular Center encourages all patients and family members to learn more about conditions and diseases that affect the cardiovascular system. The links below provide more information about vascular conditions and diseases that might be treated within this program.

Chronic Venous Insufficiency

Chronic venous insufficiency occurs when the leg veins do not allow blood to travel back to the heart.

Deep Vein Thrombosis (DVT) / Thrombophlebitis

Deep vein thrombosis (DVT) occurs when a blood clot develops in a vein deep in the body.

Pulmonary Embolism

A pulmonary embolism (PE) is a blood clot that develops in a blood vessel elsewhere in the body (most commonly from the leg), travels to an artery in the lung, and forms an occlusion (blockage) of the artery.

Thrombosis

Thrombosis occurs when clots obstruct veins (blood vessels that carry blood from the body back into the heart) or arteries (blood vessels that carry oxygenated blood away from the heart to the body).

Varicose Veins

Varicose veins are enlarged veins that are visible through the skin and may appear as blue or purple twisted, knot-like cords.

Support and Wellness

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Healthy Eating

Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

News and Events

03/31/2009: Vascular Center physicians keep marathoner in the race
Ana Gamboa Webelman has suffered four venous thromboembolic events, or deep vein blood clots, during her lifetime. The clots threatened to end her days as a runner until Robert Schainfeld, DO, and Stephan Wicky, MD, physicians at the Massachusetts General Hospital Vascular Center, were able to diagnose and treat the underlying cause of the clots - May-Thurner syndrome.

03/18/2009: DVT: What you should know
Massachusetts General Hospital to join landmark trial for the prevention of Post-Thrombotic Syndrome.

10/02/2008: Quick action helps woman recover from DVT and serious complications
Nancy Hammer never thought about her vascular health until a day of shopping left her in serious pain. There she was diagnosed with deep-vein thrombosis (DVT).

Explaining varicose veins

Julianne Stoughton, MD, explains how Mass General physicians identify varicose veins, which are enlarged veins visible through the skin, and use minimally invasive techniques to treat this condition.

Vascular Center

55 Fruit Street
Boston, MA 02114

Phone: 877-644-8346
Hours: 8:00 am to 5:00 pm


Vascular Center at Waltham52 Second Avenue, Suite 2100
Waltham, MA 02451
Phone: 
877-644-8346
Hours:
8:00 am to 5:00 pm
Learn about our convenient Waltham location

Request an appointment at the Vascular Center

Contact the Vascular Center to schedule an appointment with one of our vascular specialists

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