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Varicose Veins

Varicose Vein Treatment Types

ClosureFast™ Procedure


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VeneSeal™ Procedure


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First-line therapy for patients with symptomatic varicose veins and venous insufficiency often consists of simple, non-invasive management strategies.

Compression hose come in a variety of lengths and strengths that can be tailored to the needs of an individual patient.

Compression hose minimize swelling of the veins, and decrease leakage of fluid from the veins into the adjacent tissues.

Compression hose can help control leg swelling and can provide symptom relief for many patients.

Leg elevation is another simple, non-invasive way of reducing pressure in the veins.  Leg elevation often partially alleviates the discomfort of venous insufficiency. Unfortunately prolonged periods of leg elevation are not practical for active people. Furthermore reduction in movement and mobility (when elevating the leg) poses challenges for maintaining weight control and cardiovascular health.

Although difficult to achieve, obtaining / maintaining an ideal body weight tends to lessen symptoms in patients with venous insufficiency.

Venous ablation refers to minimally-invasive procedures designed to deliberately block-off, or close problematic veins.

These procedures leverage the concept that “blocking off” a vein simulates having the vein tied-off or “stripped”, but avoids the need for large surgical incisions.

“Closing” problematic veins reduces pressure within vein branches in lower parts of the leg. Commonly treated veins include the great saphenous vein (located on the inner thigh & inner calf) and the small saphenous vein (located on the back part of the calf).

Ablation procedures can be safely and effectively performed via tiny access sites in the lower part of the leg, using local anesthetic. The width of the skin puncture site is typically only 3-4mm in diameter, and is typically too small to require any form of suture repair.

Widely utilized methods of venous ablation include radio-frequency ablation and laser ablation. Recently the FDA has also approved devices that rotate within the vein (causing deliberate injury to the vein wall), and devices that release glue-like material into the vein (facilitating closure of the vein).

vein-ablation

At Vascular Solutions the Medtronic ClosureFastTM procedure (previously known as VenefitTM procedure) is the most commonly used procedure to close dysfunctional veins. The ClosureFast device is a specially-designed catheter that is temporarily inserted into the target vein. After administration of local anesthetic the vein can be treated without pain or discomfort. When activated, the tip of the catheter emits radiofrequency energy that permanently seals and closes the vein. After treating the vein the catheter is completely removed.

Radiofrequency ablation procedures are routinely performed in the office, and take about 30 minutes to perform. Patients are offered the option a light sedative shortly before the procedure. Patients walk out of the office immediately after the procedure, but do require someone to drive them home. Mild tenderness after the procedure is normal but typically subsides within a few days.


Courtesy of Medtronic. © 2015 Covidien. All rights reserved.

In 2015 the FDA approved the release of a “non-thermal” ablation procedure called VenaSealTM for the treatment of incompetent superficial veins in the legs.  This procedure involves using a proprietary medical adhesive to close the diseased vein. Clinical studies have demonstrated that the procedure is both safe and effective.

The VenaSeal procedure eliminates the risk of heat-induced nerve injury, avoids the requirement for injection of local anesthetic (tumescent anesthesia) along the length of the target vein, and allows immediate return to normal activity (back to work / exercise the next day).  The ability to immediately return to full activity is compelling for active people and professionals who are interested in minimizing “down-time”.

VenaSeal therapy is immediately available to patients with superficial venous insuffiency and has been successfully performed on multiple patients at Vascular Solutions.


Courtesy of Medtronic. © 2015 Covidien. All rights reserved.

Phlebectomy is a medical word used to describe the surgical removal of a vein. Often used interchangeably with the terms “micro-phlebectomy”, “stab-phlebectomy”, or “ambulatory-phlebectomy” these procedures involve tiny stab incisions (typically measuring 3-5mm in length) over the site of a superficial vein (varicosity).

The target vein is hooked (or directly grasped) and then pulled out through the stab incision. If multiple veins are present then multiple incisions may be required.

Venous blood that was previously flowing through the varicose vein auto-diverts to remaining veins in the leg.

Phlebectomy procedures can be safely performed in an office-based (or outpatient) based setting using local anesthesia.

phlebectomy

Sclerotherapy involves the injection of a medication into a vein (or cluster of veins).

The goal of therapy is to deliberately cause blockage of the vein via chemical injury to the internal lining of the vein.

A variety of medications can be used for injection sclerotherapy. Some of the most commonly utilized agents are hypertonic saline, sodium tetradecyl sulfate – STS (Sotradecol), and polidocanol (Asclera).

Sclerotherapy sessions are office-based, walk-in walk-out procedures that typically take 20-30 minutes.

Sclerotherapy procedures can be used to improve the cosmetic appearance of spider veins (<1mm in diameter), reticular veins (1-3mm in diamter), and varicose veins (>3mm in diameter).

When varicose veins are particularly large (>5-6mm in diameter), especially if the varicosity is bulging dramatically through the skin and causing significant skin-contour deformity patients may be better served with phlebectomy (surgical removal of the varicose vein), as opposed to injection sclerotherapy.

DSC_0307_sclerotherapy_resized

Occasionally leg swelling may be related to narrowing or constriction of an upstream vein. In the pelvic region this constriction is often related to external compression of the vein by adjacent structures in the pelvis. In some circumstances there may be an option for inserting a metallic stent(s) into the vein to relieve this area of constriction.

Varicose Veins
Dilated visible veins that are close to the skin surface are commonly referred to as varicose veins. Click to learn more
Symptoms
Common symptoms associated with varicose veins are aching, heaviness, tiredness, swelling and itching. Click to learn more
Diagnostic Workup
The majority of varicose veins problems can successfully evaluated with non-invasive ultrasound testing. Click to learn more