Minimally Invasive Treatment
for Superficial Venous Reflux
MIMC - January 5, 2004
Jan. 5, 2004--A new minimally invasive technology for treating superficial venous reflux is now available in Mobile. It is VNUS (pronounced venous) Closure, and it treats the underlying cause of many varicose vein problems, which are painful and unattractive. The condition can be caused by many factors including genetics, obesity, pregnancy, hormonal changes, work or hobbies that require extensive standing, and past vein diseases. Though it is most common in women older than 50, it affects men and women as young as 18.
A leading cause of this unattractive medical condition is "incompetent" valves in the large saphenous vein running from groin to ankle in each leg. When those valves deteriorate, blood flows backward instead of surging toward the heart. This places increasing amounts of pressure on vein walls, which stretches them, builds up fluid in the legs, and causes other veins to deteriorate. The condition can cause swelling, painful and unsightly varicose veins, and if left untreated, sometimes venous leg ulcers.
One option for physicians who want to address this underlying cause of leg swelling, pain, and varicose veins is to remove or “strip” the saphenous vein. To do so, the physician makes an incision in the groin and another incision below the knee, ties off the vein and removes it with a long, surgical instrument extending inside the leg to the knee. The resulting postoperative convalescence lasts two to four weeks and entails a significant amount of bruising, bleeding, and postoperative pain. This procedure is still widely done.
A different option for physicians is the Closure technology, which has been available since March 1999 when it received FDA approval. It has recently become available in the Mobile area, and only at Mobile Infirmary. Glenn Esses, M.D., the vascular surgeon who performs the procedure at the Infirmary, said, “Our patients have been extremely pleased with the results of Closure. Although I still recommend one week off work, most patients have returned to normal activities within two-three days. The patients love it. I’m glad we now have a simple, cosmetically appealing option for patients with saphenous vein reflux and varicose veins.”
A physician can now make a single, small needle size incision near the knee and insert the slender Closure catheter into the saphenous vein. The catheter is then positioned near the groin, energized with a radiofrequency generator and slowly withdrawn, sealing the vein shut. The vein is absorbed in the body and is undetectable by ultrasound after 12 to 18 months. Removing the saphenous vein does not affect circulation, as blood is redirected to other veins in the leg. There are no stitches, and swelling, bruising and pain are minimal if any in this outpatient procedure. Most patients return to normal activity within a day or two. Recent studies found that at 12 and 24 months following the closure procedure, 90 percent of treated veins remained reflux free and a significant reduction of limb pain, fatigue, and edema was observed.
For more information on the Closure procedure, please call the Infirmary Health Resource Center at 435-2508.