hgazette.com, Haverhill, MA

August 29, 2013

Here's a way to get rid of unsightly varicose veins using VNUS closure

By Walter Kwass
MD

---- — If you’re opting to wear long pants during hot summer months due to embarrassment about varicose veins, a minimally invasive procedure called VNUS closure can help.

Varicose veins — large, raised, swollen blood vessels that twist and turn — can be seen through the skin and usually develop in the legs.

It is estimated that 30 to 60 percent of adults have varicose veins. People tend to develop them as they age, and they are found more often in women.

The causes of varicose veins range from heredity to work-related conditions, obesity and injury.

Arteries carry oxygenated blood away from the center of the body. Veins, which carry that same blood back to the center of the body to be re-oxygenated, have valves inside them that help push blood against the force of gravity. When valves fail, blood pools in the veins causing them to bulge — a condition called reflux.

The two veins in the legs which most often become varicose veins are the great and small saphenous veins. The small saphenous vein runs behind the knee and great saphenous vein runs up the inner thigh. Both are superficial veins, meaning they are close to the surface of the skin.

Some people with varicose veins don’t report pain or discomfort, and for them no treatment is necessary unless, for cosmetic reasons, they prefer to have the veins removed.

Others suffer with discomfort and pain described as aching, cramping, tiredness, restlessness, burning, throbbing, tingling, and heaviness in the legs.

To reduce discomfort, it’s often helpful to elevate legs while sitting, eat a healthier diet, exercise to lose weight, reduce sodium intake to minimize water retention and swelling, and wear support hose to reduce bulging and swelling.

But for those who find little or no relief from such changes, there is VNUS closure — a minimally invasive treatment for varicose veins that uses radiofrequency heat to permanently seal the vein shut.

VNUS closure, also known as endovenous radiofrequency ablation, directs radiofrequency energy through a thin catheter inserted through a small incision in the vein. When heated, the vein produces scar tissue, which blocks the flow of blood and seals the vein.

VNUS closure can sometimes be done in an office setting using local anesthesia or a mild sedative, but some physicians prefer a hospital setting.

Closing the vein can actually enhance circulation. Blood is meant to go through deep veins, so circulation can actually be improved by sealing these veins and redirecting the blood where it is meant to go.

VNUS closure offers a much more gentle method of treatment than procedures from the past.

Originally, the method used was stripping and ligation of the vein. This means the vein was mechanically pulled and cut out of the body. It was painful, had a high morbidity rate and there was a one- to two-week recovery period.

With VNUS closure, patients are usually walking the same day and back to their normal routine within 24 hours.

Walter Kwass, MD, is a vascular surgeon and medical director of the Wound Care & Hyperbaric Center at Merrimack Valley Hospital. More information about him is available at www.steward.org.merrimack-valley by clicking on DoctorFinder.