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  Physician Consultation

  • The initial visit will include detailed explanation of venous disease and its treatment. An examination is performed by Dr Hubach including the use of a hand held Doppler to listen to the flow of venous blood in the legs.
  • After this consultation and exam, Dr Hubach will be able to determine if further evaluation and testing is necessary or if the patient can begin treatment.
  • We find this initial consult is typically covered by insurance as an office visit when symptoms are involved.


  Duplex Ultrasound Evaluation

  • If the initial consultation reveals the need for further evaluation, the patient is scheduled for an Ultrasound study.
  • The Ultrasound is done in the office by Dr Hubach - who is a certified Registered Vascular Technologist (RVT). He maps out the venous system of the diseased leg, or legs, to find the location of the patient’s abnormal veins. He is then able to discuss a treatment plan, specific to that patient, at the time of the Ultrasound.
  • Holding the credential of an “RVT” shows that Dr Hubach has been tested in use of the Ultrasound and has passed the needed written exams to be certified. This is required by some insurance companies in order to reimburse for performing the ultrasound evaluation. Very few physicians hold this credential, the ultrasound is usually performed by a technician, not the physician themselves.


  Endovenous Laser Ablation

  • This is a procedure that is performed in the office with local anesthesia. It is typically used to treat abnormal straight veins under the skin.
  • Through a needle puncture entry on the leg, a catheter is placed inside a diseased vein. Laser energy is then able to be released inside the vein and close the targeted vein segment. Over time, the body absorbs the treated vein and it disappears.
  • After the procedure, a compression hose is placed on the leg and the patient is put on a treadmill for a 15 minute walk.
  • Endovenous laser treatment is a minimally invasive, in-office treatment alternative to surgical stripping of the great saphenous vein.
  • Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day.
  • Endovenous laser treatment is FDA approved.

  Ambulatory Phlebectomy

  • Ambulatory phlebectomy is usually performed in a doctor’s office using local anesthesia.
  • After marking the location of the abnormal veins and cleaning the skin, the area surrounding the varicose veins are flooded with anesthetic fluid. Small 2 to 3 mm openings in the skin are then used to insert a small hook and the varicose veins are gently grasped and removed.
  • Ambulatory phlebectomy is often performed in conjunction with minimally invasive endovenous catheter procedures.


  Ultrasound Guided Chemical Ablation

  • Ultrasound Guided Sclerotherapy (Echo-Sclerotherapy) is an in-office treatment alternative to surgical stripping. Ultrasound imaging is used to guide a needle into the abnormal vein and deliver medication to destroy the lining of the blood vessel and seal it shut. Ultrasound guided sclerotherapy is primarily used to treat large veins beneath the surface of the skin.



  • Sclerotherapy is a common treatment for small (spider veins) and medium size (reticular) veins. Sclerotherapy uses a hypodermic needle to inject a solution (called a sclerosant) into veins, which destroys or seals closed the unwanted vessels. Depending on the size and location of the veins, different types and strengths of sclerosants are used.


  Intense Pulse Light (IPL)

  • Laser and intense pulsed light (IPL) can be used to treat small spider veins and facial redness. Pulses of light energy are directed through the skin at the blood vessels. The hemoglobin in these vessels absorbs this energy in the form of heat and cauterizes the vessels closed.
  • IPL can also be used to treat flat brown patches of pigmentation on the skin and is an excellent treatment for facial rosacea.

Skin Care Services

  • Dr Hubach uses a combination of services to offer skin care for commonly encountered conditions including:  Rosacea, acne, age spots, spider veins, sun damage, and fine wrinkles
  • A wide range of prescription strength skin care products by Obagi can be tailored to the patients specific skin care needs, transforming the skin to look and act younger and healthier

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