Nonsurgical Technique Treats Varicose Veins With Heat
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
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
"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.
There were three incidences of clot formation, which can cause a serious
condition known as pulmonary embolism if clots travel to the lungs.
- 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.