Your body's network of veins includes superficial veins, located close to the surface of the skin; deep veins, which are larger and run through the leg's deep tissue; and perforator veins, those that connect the superficial veins to the deep veins. Healthy veins have valves that open and close to keep the blood flowing out of your legs and back toward your heart. Superficial venous reflux is a condition that develops when these valves in the veins close to your skin become damaged or diseased. This causes blood to pool in your legs, leading to pain, swelling, leg heaviness and fatigue. It also can lead to varicose veins, and skin changes and skin ulcers.
The VNUS Closure procedure is performed on an outpatient basis. Using ultrasound, your physician will position the Closure catheter into the diseased vein through a small opening in the skin. The tiny catheter delivers radiofrequency energy to the vein wall. As the energy is delivered and the catheter is withdrawn, the vein wall heats up. The collagen in the wall shrinks and the vein closes. After the diseased vein is closed, other healthy veins take over and empty blood from your legs. After the procedure, a bandage is placed over the incision and compression may be applied to aid healing. Your doctor may encourage you to walk, and to refrain from extended standing and strenuous activities for a time.
During a stripping procedure, the surgeon makes an incision in your groin and ties off the diseased vein. Then a stripper tool is threaded through another vein and is used to pull the diseased vein out of your leg through a second incision just above your calf. The VNUS Closure requires no groin surgery and may eliminate the bruising and pain associated with vein stripping. Vein stripping usually is done in an operating room under general anesthesia. Closure procedures are done on an outpatient basis, typically using local or regional anesthesia.
At two years following treatment, patients who had undergone the procedure reported better quality of life compared with vein-stripping patients. Follow-up studies show that 87 percent of the veins treated remain closed at five years. In a comparative study published in the August 2003 Journal of Vascular Surgery, the Closure procedure showed better outcomes over vein-stripping surgery. In the most recent of three trials included in that study, Closure patients typically experienced less post-operative pain and bruising, resumed normal activities within one day and returned to work more than a week earlier than vein-stripping patients.
Many patients return to normal activities within a day. For a few weeks, your doctor may recommend a regular walking regimen and suggest you refrain from heavy lifting or prolonged periods of standing. Noticeable improvement in symptoms usually comes within one to two weeks. Patients report minimal to no scarring, bruising or swelling.
Some 25 million Americans, the majority of them women, suffer with varicose veins. The most important step in determining whether the procedure is appropriate for you is a complete ultrasound exam by your physician. As with any medical procedure, the Closure procedure is not suitable for all people and there are risks and considerations. Talk with your doctor to determine whether this is the right path for you.
Many insurance companies are paying for the procedure in part or in full. Most determine coverage for any treatment based on medical necessity. The VNUS Closure procedure has positive coverage policies with most major health insurers. Ask your doctor about insurance when you have your consultation.