New Treatment for Varicose Veins
N E W Y O R K, April 9, 2002 -- Twisted rope-like veins bulge out of the legs of 50 percent of women in the United States, according to the American Academy of Dermatology.
Varicose veins can be more than just plain ugly. The unsightly veins can cause pain, swelling or itching severe enough to drive many sufferers to seek medical help.
Over the years, several procedures for treatment have surfaced, but most have been somewhat invasive.
A relatively new procedure that's being used in about 100 doctors' offices around the country is said to be far less invasive, painful and time-consuming than the current most popular procedure, known as vein stripping.
Seeking Closure
Mark Adelman, director of vascular surgery at Bellevue Hospital in New York City, says a procedure known as VNUS, or "closure," is a great option for patients who've been putting off a varicose vein procedure because of the pain and recovery time traditionally involved.
"The procedure itself is not painful at all and after the surgery the patients resume the normal day-to-day activities without pain," Adelman said on ABCNEWS' Good Morning America.
VNUS, which uses a radio frequency to close the troublesome vein, can be done while patients are under localized anesthesia, and patients usually recover completely in one to two days, Adelman said.
Varicose or "enlarged" veins that sit just under the skin of the leg have numerous causes. The most common cause is a valvular dysfunction of the main vein on the leg. That vein should allow blood to pass through the leg to the heart and close so blood doesn't pass back. When it's dysfunctional, the blood can pass back, causing the enlargement.
More women suffer from varicose veins than men because it's worsened by estrogen stimulation and by anything that puts pressure on the abdomen, like obesity or pregnancy. Only 20 percent of American men suffer from varicose veins.
Throbbing Pain
Lynette McCollum has been trying to cope with her own varicose veins for five years. The 38-year-old Broadway performer and mother of two said she's tried every trick in the book to try and relieve the pain of the veins — but support hose and dieting hasn't helped. "It's painful, the throbbing and the heaviness of the leg," she said.
McCollum hasn't been willing try traditional varicose vein removal procedures because they seemed too invasive to her. Vein stripping, the most commonly used procedure, is very effective, according to Adelman, but recovery can be difficult, he said. It entails two incisions on the leg — one at the ankle and one at the groin.
A wire is then passed through that main vein, which is pulled out. Once it's removed, several smaller incisions are made that remove the small branches of blood vessels off the main vein. The trauma of the tearing causes recovery to be uncomfortable, with bruising and an irritation of the nerves that could cause numbness, Adelman said.
With VNUS, there is only one incision at the ankle. A small catheter the size of a piece of spaghetti is passed through the vein and travels to the groin where a trigger is pulled. That opens prongs on the catheter, which contact a wall of the vein. The radio frequency is then turned on and the heat closes the vein.
Becoming Invisible
Since no blood remains in the vein, it becomes invisible, and not in position to feed the smaller branches. According to Adelman, there's no bruising and very little swelling or numbness associated with this treatment, but it takes about two to three weeks for the vein to completely disappear.
About 10,000 VNUS (www.vnus.com) treatments have been carried out since the Food and Drug Administration approved its use in 1999.
The cost of the procedure is comparable to vein stripping, which ranges from $2,000 to $4,000 per leg. Closure usually costs around $2,000 to $2,500. Some insurers cover it interchangeably with vein stripping as a medical necessity, not just a cosmetic procedure, but some insurers are just becoming aware of it, said Adelman
Other varicose vein removal procedures include sclerotherapy, which treats both spider and varicose veins. It consists of injecting a solution into the vein and bandaging the area tightly for about 24 hours. A yellow-brown discoloration can sometimes appear in the treated area. This may take weeks or sometimes months to fade.
Laser therapy also may be used to treat spider veins. Sometimes more than one treatment is needed.
While high-tech treatments have become available, experts say there are ways to ease the discomfort associated with varicose veins. Support hose and tight-fitting elastic stockings can help prevent blood from pooling in the legs and increasing pressure on veins with damaged valves.
Elevating the legs to help gravity drain blood out of the leg veins is often recommended as well.