Varicose veins are enlarged superficial veins that are visible just under the skin. They can be hereditary or brought on during pregnancy. They can be caused by physical trauma or, very rarely, the result of a tumor. Varicose veins can affect men, but are most common in women. According to the National Institute of Health, approximately 25 million Americans have this condition with symptoms ranging from mild to severe.

“I am pale skinned and could always see some veins on my legs,” states Rachel, a petite Waltham resident. “The veins at the back of my legs really became noticeable toward the end of my first pregnancy. And,” she adds, “ after giving birth to my 9 pound 7 ounce son, the veins stayed.”  Over the course of seven years and the delivery of two more big babies, Rachel’s veins became even more pronounced. When she consulted her physician, she was told that the condition was most likely hereditary.

“It was emotionally difficult,” states Rachel. “As the varicose veins worsened, I stopped wearing shorts in the summer and avoided going swimming. Even in hot weather, I managed to fool myself into believing that I simply preferred to wear capris or lightweight summer slacks. Of course, I always wore tinted stockings with skirts and dresses.”

Today, Rachel chooses shorts, doesn’t hesitate to wear a bathing suit and has come to view her varicose veins as just one of many ways her body has changed over time. “I’m lucky though,” she quickly states. “For me, appearance has been the only problem I’ve experienced. I know many women who have really suffered with a lot of pain and discomfort.”

Common Causes

Normally functioning veins contain valves that keep blood moving forward toward the heart. When valves are not functioning properly, blood remains in the vein and begins to pool. This causes the vein to become enlarged. One result is varicose veins, which predominantly occur in the legs, but may occur elsewhere. Congenitally defective valves, a blood clot in a vein, and pregnancy are the most common causes of this condition. Prolonged standing and increased pressure within the abdomen can cause some people to be more susceptible to developing varicose veins, or can aggravate an existing condition.

Traditional Treatments

Treatment depends largely on the severity of one’s condition. Personal preference can also come into play as some people request removal of their varicose veins to improve their appearance.

In mild cases or early onset of the condition, physicians recommend that standing for long periods be avoided, and that legs be elevated when resting or sleeping. Wearing elastic support hose can also help diminish mild aching.

In severe cases, two forms of surgery have served as the primary forms of treatment. One treatment is vein stripping and ligation, in which the vein is removed or stripped from the body. Another is sclerotherapy, which involves injecting the vein with a solution that closes the vein.

New State-of-the-Art Procedure

For many women, severe swelling, itching, burning and pain can accompany varicose veins. In contrast to Rachel, Jill of Ashland, Massachusetts, had varicose veins that caused her legs to swell and ache horribly. Two years ago she decided to undergo surgical vein stripping.

According to Jill, she experienced a high level of pain following that procedure. Her entire leg was badly bruised and swollen. During recovery, she had to remain off of her feet for a week. Her legs had to be wrapped and kept in an elevated position. The procedure also resulted in her developing a limp. According to Jill, “I would never go through that procedure again.”

At Newton-Wellesley Hospital, Ronald Gembarowicz, MD, and Joanna Sentissi, MD offer VNUS closure, a new, virtually pain-free treatment for varicose veins. The minimally invasive surgical procedure is performed with a state-of-the-art radio frequency device. As Dr. Gembarowicz explains, “The surgery uses a catheter that is inserted into the vein through a very small opening and releases electromagnetic radio frequency waves that cause the vein to collapse.” Dr. Sentissi further explains that, “The vein wall is heated to approximately 85º, causing the vein to collapse. It flattens and becomes a fibrous cord. Once the enlarged veins are closed, remaining healthy veins become dominant in carrying on normal blood flow to the heart.”

Jill recently underwent this new procedure at Newton-Wellesley Hospital. Having experienced two different surgical treatments for varicose veins, she states, “I wouldn’t go back to the old way and that’s for sure. It was so much different – like night and day – and virtually pain free.” In contrast to her previous vein stripping surgery, she required little recovery time. The active mother of three had only a small area of bruising. She was able to drive and resume her normal activities the day after the surgery.

Before (below left) and after (below right) images courtesy of VNUS Medical Technologies, Inc., and Robert Merchant, MD.

Dr. Sentissi, a vascular surgeon at Newton-Wellesley explains, “Because the vein is not being stripped, bruising is minor and only occurs at the site at which the catheter is inserted. Also, recovery time is typically 24 to 48 hours and any swelling is reduced within 72 hours.” Unlike sclerotherapy, which also flattens the veins, VNUS closure does not result in scarring.

The state-of-the-art surgery is performed at Newton-Wellesley on an outpatient basis. It requires only local anesthesia and is performed in under an hour. As Dr. Gembarowicz adds, “Patients usually leave the hospital about 90 minutes after the procedure is performed.”

Like all surgical procedures, there are risks, including infection, bleeding, blood clots, the possibility of skin burning, minimal bruising and swelling. Also, Dr. Gembarowicz explains, “The procedure is not miraculously effective in some cases. When there are extremely large, bulging veins, a follow-up treatment is usually necessary.”

Nearly 100 VNUS closure surgeries have been performed without incident at the hospital in the past year. As Dr. Sentissi states, “Feedback from the majority of patients is extremely favorable.”

For more information or to schedule an appointment, call CareFinder, physician referral service, at 1-866-NWH-DOCS (866-694-3627).

 

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