Minimally Invasive Treatment of Varicose Veins
More than 25 million Americans suffer from symptomatic varicose veins and many more are afraid to show their legs because of unsightly bulging or spider veins. This problem is more common in women who frequently develop superficial venous disease during pregnancy, and the condition worsens with subsequent pregnancies. Approximately 50% of the population over 50 years old have some form of this disorder. There is a large genetic component to this disease, and it is common for multiple members of a given family to be affected. In addition, people with lifestyles or jobs that require standing for prolonged periods are also at risk.
Varicose veins are primarily due to dysfunctional valves in the superficial leg veins that allow blood to reflux rather than return to the heart. This pooling of blood causes veins to dilate and gives rise to varicose veins and clinical symptoms including burning, aching, itching, and throbbing. In order to effectively treat the problem, the leaking valves have to be identified and sealed.
The disease is diagnosed and classified in severity on physical examination and ultrasound imaging. Utilization of non-invasive color-duplex ultrasound technology allows vascular surgeons to identify the source of the varicose veins and develop a precise treatment plan. New catheter-based treatments are now available which effectively seal the leaking valves and eliminate the varicose veins without the need for ligation and stripping. These catheters impart a heat injury to the vein wall that causes an inflammatory reaction and closure of the incompetent vein. Small two-millimeter incisions (microphlebectomy) are then used to remove the residual varicose veins.
The procedure, performed in an outpatient setting under either local or general anesthesia, usually takes one to two hours. Patients recover for approximately one hour and are discharged home. They are required to wear a compression dressing for three days. There is little or no postoperative pain, and patients are able and encouraged to ambulate immediately. Return to work and full activities are faster than with traditional ligation and stripping.
Using the Closure® system from VNUS Medical Technologies, Inc., Dr. Levin has achieved > 95% effectiveness since he started the program four years ago. With the advent and use of the new Closure Fast catheter, 100% effectiveness has been realized. Nationwide, reports of 95% success rate with this procedure are common.