Help for Venous Reflux Disease

By Dr. Steven Kaufman

Nearly 25 million Americans have venous reflux disease, a condition that affects the veins in the legs. When valves in the veins become damaged or diseased, they fail to close properly, resulting in inadequate return of blood from the legs to the heart. This results in blood pooling in the legs, and the increased pressure in the veins causes leg pain, swelling and fatigue, as well as skin changes and varicose veins. Causal factors of the disease include age, gender, heredity, history of multiple pregnancies, and a profession that requires prolonged standing. If not treated, venous reflux disease is progressive.

The traditional treatment for venous reflux disease has been “vein stripping,” a painful procedure that requires up to four weeks of recovery time. It has a success rate of 60-70% at five years. Thanks to advances in medical technology, there are less traumatic alternatives. These involve endovenous techniques that enable the surgeon to close the diseased vein from the inside rather than requiring its removal. The most commonly used (65%) technology, called Closure®, employs radiofrequency energy. Its provider, VNUS Medical Technologies, furnishes medical devices for the minimally invasive treatment of venous reflux disease. Closure® requires only one or two days for recovery, and it has a success rate of 89% at five years. Laser treatment (35%), known as EVLT®, operates at much higher temperatures than radiofrequency Closure®, resulting in more vein perforations, bruising, and post-operative pain than after radiofrequency treatment. Recent data presented at the Congress of the American Society of Phlebology indicates a three-year success rate of 55% for laser treatment.

After a consultation, a surgeon who specializes in performing the Closure® procedure assesses the venous system for reflux using ultrasound. If reflux is demonstrated, the doctor may offer Closure®, but may suggest adjunctive treatments such as phlebectomy and sclerotherapy, to increase effectiveness of the overall treatment. Sclerotherapy injection of a detergent agent that irritates the insides of the vein, thereby facilitating closure, is sometimes used when the vein is “tortuous”(corkscrew shaped) and will not permit placement of a long rigid catheter into the vein. Radiofrequency treatment is now available for treatment of perforating veins, which used to require incisions to treat.

Closure® is performed through a small puncture through the skin into the vein being treated. This access is guided by ultrasound. The Closure® catheter is then introduced into and properly positioned in the vein, after which local anesthetic is injected. No general anesthetic or sedation is required. The radiofrequency generator is then activated, delivering energy to the vein wall, causing collagen to contract, leading to shrinkage of the vein. The catheter is slowly withdrawn until the diseased vein is closed. Blood is then re-routed to surrounding healthy veins. The procedure takes less than an hour to complete. It is recommended that patients wear compression stockings for approximately one week after surgery.

If you suffer from the symptoms of venous reflux disease or varicose veins, rest assured there are alternative treatments that can get you back on your feet faster than ever before, relieve pain, fatigue, and swelling, and provide a solution for the unsightly appearance of varicose veins.

Published in Northern Colorado Woman’s Paper,
January-February 2006, page 8

To determine which treatment option is recommended for your individual situation, please call 970-498-VEIN (8346) to schedule a consultation.