New Minimally Invasive Treatment For Varicose Veins

DANBURY — Approximately 20–25 million Americans have varicose veins. Venous reflux, often the underlying cause of varicose veins, frequently forces people to dramatically change their lifestyle, especially when they have a standing profession and can no longer tolerate being on their feet all day.

Whether the initial cause is genetics, pregnancy, prolonged standing, excess weight, inadequate exercise, or a damaged saphenous vein, the physiology of varicose veins 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. These dilated superficial veins are commonly known as varicose veins. Venous reflux (caused by incompetent valves) in the saphenous vein is often the underlying cause of varicose veins. Although the condition is rarely life threatening, it is often painful and unattractive.

The VNUS Closure procedure is an outpatient (day surgery) treatment now offered at the Vein Care Institute by Alan M. Dietzek, MD, medical director, who also serves as chief of the section of vascular surgery at Danbury Hospital.

“The VNUS Closure procedure is a true advance in the treatment of superficial venous insufficiency,” said Dr Dietzek. “It has replaced saphenous vein stripping at the Vein Care Institute, with offices in Southbury and Danbury, as the treatment of choice for this disease entity.”

The Closure system is patented technology that uses radiofrequency energy to occlude, or seal shut, the saphenous vein. The physician typically makes a single, small incision near the knee and inserts the slender Closure catheter into the saphenous vein. The catheter is then positioned near the groin, energized, and slowly withdrawn, sealing the vein shut. There are no stitches involved, and most patients return to normal activity within a day or two.

During traditional vein stripping surgery, incisions are made in the groin and calf, and a stripper tool is threaded through the diseased vein, to pull the vein out of the leg. Recovery after the surgery may last weeks, and typically causes significant bruising and can create postoperative pain, nerve damage, and poor short-term cosmetic outcomes.

“Until recently, stripping was the best procedure for the treatment of a symptomatic saphenous incompetence,” Dr Dietzek said. “Because of the pain and discomfort associated with the stripping procedure, however, many patients did not seek help. Alternatively, following the Closure procedure there is usually minimal or no pain and patients are eager to seek treatment.”

According to Mary Ann Piasecki of Southbury, an active mother of two, the Closure procedure was a quick and effective.

“I had varicose veins,” she said. “The pain in my left leg was slowly increasing, and I couldn’t walk or stand for long periods of time. I read about this procedure and discussed it with my family doctor, who referred me to Dr Dietzek..

“It was remarkable. Very seldom do you read about something and it actually happens the way it was described. I had to rest and reduce my activity for 24 hours, but that was it. The pain is gone and the procedure dramatically improved the appearance of my leg,” Ms Piasecki said.

The results of three randomized trials comparing the Closure procedure with traditional vein stripping surgery demonstrate that patients who received the Closure procedure consistently experienced less postoperative pain and returned to normal activities and work faster than patients whose veins were surgically stripped.

In addition, the Closure procedure has proven to be highly effective, with higher than 90 percent of veins treated remaining reflux free at two years. Ninety-eight percent of patients who have undergone indicated they would recommend the Closure procedure to a friend with similar leg vein problems. More than 75,000 patients have been treated with the Closure procedure to date. For many patients, the procedure is covered by their health insurance.

Like other venous procedures, the Closure procedure involves risks and potential complications. Patients should consult with their doctor to determine whether or not they are candidates for this procedure, and if their condition presents any special risks.