After completing his General Surgery Residency here at the University of Tennessee, Knoxville in 2010, Dr. Milligan received additional vein training from Dr. Frederick Elmore in Fresno, California. He then worked as a general surgeon in Crossville, TN and started his first vein clinic. In 2013, he switched to solely focus on venous disease and joined Dr. Steven Roth, a vascular surgeon and founder of The Vein Guys in Nashville, Tennessee. Since starting vein treatments, he has performed over 8000 procedures for venous reflux disease, with a DVT rate of 1/1400 cases vs. a national average 7/1000.

It is estimated that over 30 million Americans suffer from vein disease. Whether the initial cause of venous insufficiency is genetics, pregnancy, a previous DVT, prolonged standing or obesity; the physiology is nearly always the same. The valves in the saphenous vein are damaged and the veins near the skin surface are stretched and distorted from the increased pressure caused by blood flowing in the wrong direction. Although the condition is rarely life-threatening, it is often unattractive, painful and can cause patients to curtail normal activities.

Symptoms of Venous Reflux Disease:

• Varicose veins
• Burning / Itching in the legs
• Leg / Ankle swelling
• Leg cramps
• Aching / throbbing in the legs
• Restless legs
• Leg skin color changes
• Venous ulcers

Venous Insufficiency by the numbers:

• 72% of women and 42% of men will experience symptoms of venous insufficiency by the time they are in their 60s.
• 2.5 million Americans suffer from venous stasis ulcers.
• 500,000 new patients are diagnosed with venous stasis ulcers yearly.
• Over 2 million workdays each year are lost due to symptoms and complications associated with venous stasis ulcers.
• Each year U.S. payers spend a combined $14.9 billion on managing venous leg ulcers.

Historically, patients have had several choices for treating varicose veins, depending on the severity of their condition. They could make lifestyle changes, such as eating less, exercising more and wearing support hose; this regimen has proven helpful in mild cases, but relief is usually short term. Historically physicians advocated the removal or stripping of the saphenous vein which is a more invasive surgical procedure performed in the hospital setting. Recovery after stripping surgery typically took several weeks and the patients had significant bruising, post-operative pain, nerve damage and poor short-term cosmetic outcomes. Dr. Milligan encourages patients who suffer from varicose veins to choose less invasive office based procedures.

Offering differing modalities has the advantage of letting Dr. Milligan choose the right treatment for each patient. He is currently the only physician in the state trained in the Venaseal procedure used to treat venous insufficiency. All of these procedures are performed in his offices in Knoxville and Crossville. Patients return home after the procedure and usually return to their normal activities the next day.

Following procedures, patients generally experience significant improvements in their leg symptoms. The legs will feel lighter and have more energy. The patient will be able to sleep thru the night without restless legs or leg cramps. Leg swelling will improve. Varicose veins will shrink; giving the patient better cosmetic results and pain free veins. Leg ulcers will heal faster and have a lower reoccurrence rate.

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