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.