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(Ivanhoe Newswire) -- Twenty-five-million Americans -- or half of all men and women over age 50 -- have varicose veins -- veins that become damaged and fail to regulate blood flow from the legs to the heart. They're bulging and unsightly and can lead to fatigue and pain. Now, there's a quick new treatment for varicose veins that gets patients back to their routine faster than ever.
Lately it's been Amelia the dog doing all the dancing at Dave Schwartzman's house. He says his left leg often feels tired and heavy. The reason: varicose veins.
Schwartzman is undergoing a new procedure to treat the problem. It's all done under local anesthesia. Vascular surgeon Dr. Ken Adcock uses ultrasound to go inside the vein with a catheter, then a radio frequency probe.
Radio frequency energy is used to heat the vein from inside, causing the vein wall to contract and close. This redirects the blood to other healthy veins. The treatment takes just a few minutes and Dr. Adcock says it's also easier on the patient.
Other varicose vein treatments, like laser or vein stripping, can leave bruises that can last for days. But with this procedure, Dr. Adcock says there's virtually no bruising or pain, and patients can return to regular activities in just 48 hours.
"I've been performing vascular surgeries for almost 25 years now and this is a quantum leap forward," Dr. Adcock says.
"I was surprised at how quick it took, and really pain free and that's not an exaggeration it was pain free," Schwartzman says.
Doctors aren't sure what causes varicose veins. They do know the condition runs in families, and is more common in women and men. Also varicose veins seem to occur more often in people who spend many hours a day on their feet.
RESEARCH SUMMARY:
BACKGROUND: It's estimated that 72 percent of women and 42 percent of men have varicose veins by age 60. Varicose veins are veins that have become dilated, dysfunctional or twisted. Varicose veins affect one out of two people over age 50 (Source: NIH). These veins are commonly found on the backs of the calves or on the inside of the leg. They develop when valves in the veins that allow blood to flow toward the heart stop working properly. As a result, blood pools in the veins and causes them to get larger.
Besides cosmetic problems, varicose veins tend to be bulging and unsightly. They are often painful, and can cause swelling, leg ulcers, delayed healing of wounds on the legs, and other health problems. Doctors still don't know exactly what causes varicose veins, but they do know that they seem to run in families and are more common in women than men. Obesity and pregnancy can also increase the odds a person will develop varicose veins.
TREATMENT: Until recently, there have been two main options for treatment of varicose veins, both generally done as outpatient procedures: vein stripping, which is usually performed under general anesthesia, and endovenus laser treatment, a less invasive procedure, generally done in a doctor's office under local anesthesia. Goals of vein stripping are to relieve pain, and to improve circulation through the venous system by removing pathways of blood reflux. Vein stripping involves the removal of the saphenous vein in the leg and any varicose tributary veins. Laser ablation sends intense bursts of light onto the veins to seal them off, causing them to dissolve over time. It generally takes less than an hour and gets patients back to their regular activities with less down time than the vein stripping method.
A NEW ALTERNATIVE: The FDA recently approved a new treatment for varicose veins that uses radio frequency energy. The treatment, called the VNUS ClosureFAST catheter is much faster, less invasive, and has a very quick recovery time, compared to other available treatment options, according to vascular surgeons now performing the procedure. This varicose vein treatment uses ultrasound to guide a catheter into the vein, then as this catheter is removed, radio frequency energy heats the vein, causing the vein wall to contract and the vein to close. The entire procedure takes just a couple of minutes and the patient is able to go home within about an hour.
Orlando
vascular surgeon G. Kendrix Adcock, M.D., calls this technique, "a lot less traumatic to surrounding tissues and a lot better as far as patient comfort," noting that patients who undergo vein stripping or laser treatment for varicose veins can experience bruising and pain that last for days. Dr. Adcock says another advantage for patients is that, "the recuperative phase is so short they're able to get back to normal activities faster. A lot of these people engage in running, power walking, yoga, those kinds of activities, and they're able to return to them very, very quickly." Generally, patients are able to return to regular activities in about 48 hours. Dr. Adcock adds, "I've been practicing vascular surgery for almost 25 years now, and this is a quantum leap forward."
IN DEPTH DOCTOR INTERVIEW:
G. Kendrix Adcock, M.D., talks about a new vascular surgery to remove varicose veins…
Why do people get varicose veins?
Dr. Adcock: Varicose veins are caused by a number of reasons, a lot of which are not totally understood. We just know varicosities tend to run in families and unfortunately strike women more than men. They are also more frequent with multiple pregnancies, obesity, and a number of other conditions.
Describe the vascular surgery procedure you perform to remove varicose veins.
Dr. Adcock: First we numb the patient. Then we access the vein and put a little sheath up to work everything through. We then use a radiofrequency probe, positioning it where the deep and superficial systems come together in the groin. We put tumescent around the catheter to serve three purposes. The most important one is to anesthetize the area. It also collapses the vein down and protects the surrounding tissues from the radiofrequency energy.
If you look at out monitor, you can see the tumescent tracks along the catheter. The bright dot in the center and the fluid around it are the tumescent. It tracks up the sheath around the greater saphenous vein.
Using the ultrasound, we then look up and down the track and around the catheter to make sure we have the tumescent all along it. We want the tumescent thoroughly in the area where the vein will be treated. We then institute a couple of cycles of radiofrequency.
The catheter is heated to 120 degrees centigrade. We treat the initial part of the vein in two cycles. The nice thing about this is the closure fast catheter treats the veins in seven centimeter segments at a time.
Next, we interrogate the vein to make sure there is no flow to the greater saphenous vein. We put a little color flow in there to detect even the most minute amount of flow. Then we will go up to where the saphenous vein empties into the deep system of veins and confirm that the deep system is intact without any problems -- without any thrombus or clot.
What are the benefits of this procedure?
Dr. Adcock: The majority of these people are very young, active, working individuals so the major benefit of this is that the recuperative phase is so short. The procedure is a lot less traumatic to the surrounding tissues and a lot better as far as patient comfort. A lot of these people engage in running, power walking, yoga and they are able to return to those activities very, very quickly. They can go back to work within 48 hours. That is a huge plus to this procedure.
How long does the procedure take?
Dr. Adcock: Typically, just a few minutes. So obviously it’s a huge savings in time and effort for patients.
What happens to the vein during the procedure?
Dr. Adcock: The radiofrequency denatures the proteins inside it, sealing the vein down. It kind of cooks the tissue and seals it, kind of cauterizes it. This will eventually shut the blood flow from this vein into the veins in the deeper part of the patient’s leg where they are more efficiently able to be taken care of. The venous return flow in his leg is more efficient.
How does this varicose vein procedure compare to previous types of vascular surgery?
Dr. Adcock: I have been performing vascular surgery for almost 25 years and this is a quantum leap forward. It almost makes the procedure that we did when I started seem archaic or like something out of the middle century. This is such a major advance.
How does this procedure compare to laser treatment, which was at one time considered a breakthrough in varicose vein treatment?
Dr. Adcock: It certainly was considered a breakthrough. I think this represents an advance because in this modality the amount of traumatic injury to the surrounding tissue is significantly reduced. The laser seems to cause more injury to the surrounding tissue and people have a longer recuperative phase.
Who would benefit from this procedure?
Dr. Adcock: Typically, patients have been preoperatively evaluated and the majority have symptoms of heaviness, swelling, and fatigue in their legs. We have done non-invasive workup and found the greater saphenous vein is not working correctly. The little valves do not work so instead of the blood stair-stepping back up the leg and going into the deep system and eventually back to the heart, the blood and pressure tends to stay in the lower part of the legs. Typically, once this procedure is done, the blood flow is shunted into the deep system of the veins where it is much more efficiently able to return to the heart.
What are the potential complications from this procedure?
Dr. Adcock: The potential complications are bleeding because we are working on a vein, but this is not usually a major issue. There is always a small chance of infection. Also, thermal injury to the surrounding tissues or reaction to the anesthesia or the prep we give can occur. About 90 percent of veins are closed at two years. However, there is a small percentage that veins will open back up over a period of time and require being retreated.
Is this procedure performed for cosmetic reasons?
Dr. Adcock: Obviously, cosmetic issues have a part in this, but most people are much more concerned about the fatigability of their leg, the swelling, and the discomfort than the way the vein looks. But obviously, in warm climate areas where people wear shorts, this helps alleviate the unsightliness of varicosities.
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