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Collapsing the vein -- New procedure for treating varicose veins gets

Peoria Journal Star, October, 2002 by JOHN O'CONNELL

For five years, Sally Meece dealt with the pain associated with the varicose vein that ran the length of her right leg.

"The pain was not too bad at first," the 47-year-old Pekin woman recalled. "But it gradually got worse. More and more I would have to get off my feet and prop my leg up in order to relive the pain."

Within the past year, the vein in Meece's right leg swelled, bulging to the surface with three large knots.

"It didn't look very good, but I didn't have the worst case by far," she said. "I want to make it clear that it wasn't for cosmetic reasons that I got treatment. It just became too painful for me. And I was really concerned with blood clots forming."

She wore a surgical support stocking to alleviate the pain. When she found herself having to wear the stocking to bed, she began looking for a more permanent solution.

The traditional treatment is vein stripping. This involves tying off the saphenous vein and using a tool to remove, or strip, the vein from the leg. In a vast majority of cases, a faulty saphenous vein, which runs down the inside of each leg from the groin to the ankle, is the source of varicose veins. Once the vein stripping procedure is completed blood is re-routed to healthy veins.

"Vein stripping just sounded barbaric to me," Meece said. "I would have kept wearing my support stockings."

But through research on the Internet she learned about a new treatment called Vnus Closure, a less-invasive alternative to vein stripping, according to Dr. Arthur Bishop, an interventional radiologist at Methodist Medical Center.

Closure is an outpatient treatment that is performed in an angiography suite at Methodist Medical Center, the only hospital doing the procedure between Chicago and St. Louis, according to Bishop.

Closure uses radio-frequency heat to collapse the saphenous vein. A catheter is then inserted into the vein through a small incision, above the ankle or knee, depending on how much of the vein needs to be closed off. It is then threaded through a sheath to the groin area.

As the doctor slowly pulls the catheter back, radio-frequency energy heats the vein wall, causing it to collapse and seal shut, Bishop explained. With the diseased vein sealed, blood is routed to other healthy veins deeper in the leg. A patient is typically awake during the procedure, which takes about 15 minutes. A local anesthetic is generally used to numb the area to be treated.

After the catheter has sealed the vein, it is removed and a bandage is placed over the site of the incision. The leg is wrapped for about a day. The patient goes home about an hour after the procedure.


"Most patients can resume their normal activities the very next day," Bishop said.

For Meece, the procedure was "absolutely wonderful, no pain," she said.

"I was in recovery by 10 a.m., and home by noon," recalled Meece, who was only the sixth person to have the procedure done locally.

"I went back to work the next day. I have no more pain. And the varicose vein is gone. I did have some small varicose veins that were later treated with injections that ablate the veins. My leg looks much better now, but the important thing for me is not to have that pain."

Closure causes the vein to "scar down to a fibrous cord," said Bishop, who has performed some 20 such procedures.

"We have had very good luck with this procedure," the doctor said. "In large studies, 90 percent of the veins are still closed after five years."

Closure offers several alternative advantages to vein stripping, Bishop said.

"With vein stripping there is a greater risk of infection and nerve damage," the doctor said. "And Closure generally eliminates the bruising and pain associated with vein stripping."

Vein stripping is usually performed by a vascular surgeon in an operating room under general anesthetic. It may be a week to six weeks before the patient is back to work, Bishop said.

With Closure, there is no hospital stay and you are back to work most often the very next day. An estimated 25 million people suffer with varicose veins, which have a distinctive blue color and swollen appearance.

"It's basically a plumbing problem," Bishop said.

The function of leg veins is to carry blood back to the heart. Veins have numerous valves to help equalize pressure and to assist the return of blood back to the heart. If a valve fails to open and close properly, blood flows backwards in the leg, often pooling in veins near the skin. As the blood pools, the vein is enlarged, the doctor explained.

What causes the valves to go bad? Obesity, excessive standing, heredity and pregnancy are common reasons for varicose veins, which are not considered life threatening.

If varicose veins are left untreated, it can result in chronic venus stasis, a discoloration at the ankle and sometimes an ulcer, the doctor said. About 500,000 people suffer from this condition.

"This is a very painful condition that can be cleared up with Vnus Closure," the doctor said.

Bishop believes Vnus Closure will become the treatment of choice within a few years.

"Closure is a medical breakthrough," Meece said. "Varicose veins is a very common problem. The medical community needs to get this out to the public because it will help so many people."

Copyright 2002

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