March 28, 2000 (San Diego) -- A new procedure treats varicose veins by heating them, causing the tissue to contract and the vein to close, according to Mark J. Marzano, MD, speaking here at an annual meeting of interventional radiologists. The procedure was approved by the FDA in March 1999 for the treatment of saphenous veins, which run along the inner leg.
The procedure, which uses a probe inserted into the vein, has several advantages over conventional treatment for varicose veins, he says. For example, it is performed in the physician's office, and the patient typically requires only local anesthesia and, in some cases, sedation. Afterward, the patient has no sutures or dressings needing special care. Patients can return to work the next day and resume normal activities immediately - except for weight lifting, which must be deferred until a check-up one week after the procedure.
Conventional vein surgery, called "vein stripping" because it involves tying off the problematic vein and pulling it from the body, is performed in a hospital operating room. The patient is usually under general anesthesia, or in some cases, a regional block, and must rest the healing leg for about one week.
During the heat procedure, the physician uses an ultrasound machine's image as a guide when inserting the probe through a narrow tube, called a catheter, into a junction between two major leg veins, the saphenous and femoral veins.
"The catheter is connected to a radiofrequency generator that heats the collagen of the [vein walls] to 85? C," which causes the saphenous vein, which runs along the inner leg, to shrink and close off, Marzano tells WebMD. He is an interventional radiologist in private practice in Baltimore. Interventional radiologists have had additional training and use imaging techniques to treat several medical conditions.
After treatment, patients wear for three days a low-grade compression stocking, which has the approximate strength of a support stocking that can be bought at the drug store, he says.
In addition to being less painful and disabling than conventional vein surgery, the thermal procedure is also free of the recurrences associated with sclerotherapy, says Marzano. Sclerotherapy consists of injecting a solution into the vein that hardens it.
In a study conducted at 33 centers, he and colleagues tested this procedure on more than 370 legs in nearly 340 patients. Six-month follow-up data on 221 legs revealed 95% were free of congested blood. Phlebectomy, or removal of branches of the vein to enhance the procedure, was performed in 37% of original 370. "Every patient [whose veins were closed] at one week was still [closed] at six months," he tells WebMD.
Approximately 5% of patients developed numbness, which typically resolved six months after therapy. About 4% of the patients experienced skin burns. Patients whose veins were located directly under the skin were more at risk for burns. However, this complication can be prevented by injecting a local anesthetic under the skin, Marzano tells WebMD.
- Researchers have developed a new technique for treating varicose veins that involves heating the veins and causing them to close up.
- The new procedure can be performed in a doctor's office under local anesthesia, and patients can resume all normal activities the next day except for weight lifting.
- There were no recurrences associated with the procedure, and negative side effects occurred in a small number of patients, including numbness, burns to the skin, and clot formation.