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New Procedure Helps Eliminate Varicose Veins


WebMD Health News

May 29, 2000 -- Summer means shorts and swimsuits, and this can be an unhappy prospect for the approximately 25 million Americans with varicose veins -- those unsightly bluish, swollen veins in the leg.

The good news is that there are more options than ever to remove varicose veins, including a new procedure called closure that treats the veins by heating them, causing the tissue to contract and the veins to close, experts tell WebMD.

Varicose veins occur when the veins' valves are weak. Blood is supposed to flow through the veins and to the heart, but when a valve becomes damaged, blood pools and puts pressure on vein walls, causing the veins to bulge. These veins run in families and can be triggered by pregnancy, menopause, and aging. For some people, varicose veins are simply a cosmetic concern, but for others they cause pain.

To perform the new procedure, the doctor first uses ultrasound, or sound waves, to map the vein, then numbs the area with local anesthesia. The doctor then nicks the skin behind the knee and threads a small tube into the vein.

Using ultrasound, the doctor guides the tip of the tube until it reaches the point near the groin where the saphenous vein starts. The saphenous vein, which runs along the thigh, is one of the major veins of the leg.

A tiny, heated probe is threaded through the tube, shrinking the inner walls of the vein until it collapses. Once the diseased vein is shut, other healthy veins take over its job.

Traditionally, varicose veins have been removed with surgery. The surgery may involve tying off the saphenous vein, then partially or completely removing its branches, a procedure known as vein stripping. This type of surgery is usually performed under general anesthesia, and the patient must rest the leg for about a week afterward. Approximately 150,000 such surgeries are performed each year in the U.S.

Another option for varicose vein removal is called sclerotherapy, or injection therapy. In this procedure, a solution is injected into the vein to force it to clot. Unlike with the new heat therapy, varicose veins often return after sclerotherapy. And new varicose veins can sometimes develop after vein-stripping surgery.

Lowell S. Kabnick, MD, FACS, attending vascular surgeon and the director of minimally invasive venous surgery at Morristown Memorial Hospital in Morristown, N.J., has performed more than 100 closure procedures.

"Cosmetically, it's superlative to surgery because we are only leaving a puncture, as opposed to a couple of incisions," he tells WebMD. "There's less bruising, and recovery is much shorter than with the stripping procedure."

But the closure procedure cannot be performed on people whose veins are too big or too twisted, he says.

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