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Happy Legs: Improved Treatment for Varicose Veins

January 06, 2014

Varicose veins can be painful, causing itching, burning, and heaviness. They may also create swelling or even skin ulceration, and they often worsen over time.

People who are on their feet for long periods, have a family history of varicose veins, or women who have been pregnant are most prone to suffer from this problem.

Varicose veins are the result of reflux (blood backing up) in the great saphenous vein, the longest vein in the body running along the length of the leg. The blood pools, resulting in pressure, pain, and other symptoms.

Improved Treatment

The traditional treatment for varicose veins is surgically removing – or stripping – them. Patients are fully sedated, and the procedure requires large incisions and a relatively long recovery.

Today, however, vascular surgeons from the Baystate Heart & Vascular Program are using minimally-invasive venous ablation technology to cauterize unsightly and bulbous varicose veins.

The Baystate Vascular Services surgeons, Drs. Neil Hadro, Jeffrey Kaufman, and Sang Won Rhee, are the only board-certified vascular surgeons performing venous ablation in the region, and have performed several thousand procedures with great success.

Over 90% of their cases are straightforward enough to be handled in the office setting with a local anesthetic and mild sedation. The surgeons offer the procedure in their offices in Greenfield and Springfield. About 80% of their patients are women, for whom the condition is more prevalent.

Rhee explains that the technology allows more patients to receive treatment. “Patients went untreated in the past because of the risks involved. Now many doctors recommend the procedure. It’s less invasive for the patient, has a shorter recovery, and is less painful.”

Legs Look and Feel Better

While the surgeons certainly improve their patients’ appearance, cosmetic work isn’t their focus. They aim to treat pain and other symptoms of the condition.

“The procedure is done because of functional complaints that people are having,” says Kaufman, noting that the most common complaints are visible veins, pain, swelling, itching, and, in more extreme cases, venous ulcers that are associated with skin that is discolored.

“The symptoms are all unattractive, but in the overwhelming majority of patients we’ve seen, the procedure is not done for cosmetic reasons,” he stresses. “There is no insurance that covers the procedure for cosmetic purposes. The veins have to be causing symptoms.”

The Procedure

In most cases, venous ablation is performed in an office setting under a local anesthetic with ultrasound guidance. The surgeon enters the vein with a small needle and inserts a catheter or probe that is proportionate to the length of the vein to be treated. Heat delivered through a coil at the end of the catheter ablates the vein and seals it.

After the catheter is removed, the incision is generally sealed with a Steri-Strip; multiple incisions can be necessary, Kaufman says.

Some cases are best performed in an operating room. Kaufman says that if a patient requires a lot of incisions or if the case is complicated, the surgeons prefer to perform the procedure in an operating room so sedation can be used to keep the patient more comfortable.

The surgeons note that as with all procedures, there are risks. The most common after-effects include pain and discomfort. Rare effects may include infection, swelling, and blood clots, which may require some patients to take a blood thinner.

After the procedure, patients are told to return to normal daily activity but to elevate the leg – or legs – when they are able.

Baystate Vascular Services has offices at 3500 Main St., Suite 201 in Springfield and 48 Sanderson Street in Greenfield. For more information or an appointment, call 413-794-CARE (2273).