NewburyportNews.com, Newburyport, MA

PortWatch

September 21, 2007

A less-painful treatment for varicose veins

If you experience discomfort, swelling and varicose veins in your legs, you may be suffering from superficial venous reflux disease. It is a condition that develops when the valves that usually keep blood flowing out of your legs become damaged or diseased. Approximately 25 million people in the U.S. are affected by venous reflux.

The primary varicose vein treatment is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome varicose vein from the leg. During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein. Then, a stripper tool is threaded through the saphenous vein and used to pull the vein out of the leg through a second incision just above the calf.

The VNUS Closure procedure provides a less-invasive alternative to vein stripping by closing the diseased vein instead of removing it. According to research findings published in Dermatologic Surgery, two years after treatment, 90 percent of the treated veins remain closed and free from reflux, the underlying cause of varicose veins. And, because the procedure is minimally invasive, patients report less pain and a quicker return to normal daily activities.

In the VNUS Closure procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping. Vein stripping is usually performed in an operating room, under a general anesthetic, while the VNUS Closure procedure is performed on an outpatient basis, typically using local or regional anesthesia.

The VNUS Closure procedure, usually completed in 45 minutes to one hour, consists of four main steps.

* Map the saphenous vein: A typical procedure begins with noninvasive ultrasound imaging of the varicose vein to trace its location.

* Insert the closure catheter: After the physician accesses the vein, the catheter is inserted. The physician then typically injects anesthetic fluid into the area surrounding the vein. This numbs the leg, helps squeeze blood out of the vein and provides a fluid layer outside the vein to protect surrounding tissue from heat once the catheter starts delivering radiofrequency (RF) energy.


* Deliver RF energy and withdraw catheter: Noninvasive ultrasound is used to confirm the catheter tip position, and the physician then activates the RF generator, causing the electrodes at the tip of the catheter to heat the vein wall. As the vein wall is heated, the vein shrinks and the catheter is gradually withdrawn.

* Confirm closing of vein: After treatment, ultrasound imaging is used to confirm closing of the vein. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. Patients who undergo the procedure typically resume normal activities within a day.

Experience has shown that many patients with superficial venous reflux disease can be treated successfully with VNUS Closure. Check with your physician to see if you are a candidate for the procedure.

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Dr. David Swierzewski is on the staff of Anna Jaques Hospital and Atlantic Surgical Associates in Newburyport.

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