Venous Disease – Frequently Asked QuestionsWhat are varicose veins?
Unsightly and uncomfortable, varicose veins can promote swelling in the ankles and feet and itching of the skin. They
may occur in almost any part of the leg but are most often seen in the back of the calf or on the inside of the leg
between the groin and the ankle. Left untreated, patient symptoms are likely to worsen with some possibly leading to
To prevent blood from flowing in the wrong direction, veins have numerous valves. If the valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose. The process is like blowing air into a balloon without letting the air flow out again- the balloon swells.
To succeed, treatment must stop this reverse flow at the highest site of valve failure. In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which run up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.
If there are inflamed areas or an infection, topical antibiotics may be prescribed. If ulcers develop, medication and dressings should be changed regularly.
There are also potentially longer-term treatment alternatives for visible varicose veins, such as sclerotherapy and phlebectomy.
Radiofrequency Ablation Procedure – Frequently Asked QuestionsHow does it work to treat superficial venous reflux?
In the radiofrequency ablation procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping (i.e., that may result from the tearing of side branch veins while the saphenous vein is pulled out). Vein stripping is usually performed in an operating room, under a general anesthetic, while radiofrequency ablation is performed on an outpatient basis, typically using local or regional anesthesia.
Three randomized trials of radiofrequency ablation vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, radiofrequency ablation was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the radiofrequency ablation procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, radiofrequency ablation patients returned to work 7.7 days sooner than surgical patients. Patients treated with radiofrequency ablation had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.1
As with any medical intervention, potential risks and complications exist with the radiofrequency ablation procedure. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the radiofrequency ablation procedure at the consultation, and can be reviewed in the safety summary. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling), and/or skin burn.
Miscellaneous – Frequently Asked QuestionsWhat are factors leading to venous insufficiency and varicose veins?
- Heredity – If your parents and/or grandparent have varicose veins, you are at an increased risk.
- Gender – Women have higher incidence of varicose veins due to female hormones affecting the vein walls.
- Age – As we age, our tissues and vein walls loose elasticity, causing the valve system to work less well.
- Pregnancy – This causes a rise in blood pressure and volume, and hormones which all play a part in damaging the vein walls.
- Skin color & texture change in the calves and ankles
- Obesity – As a persons weight increases, so does the pressure exerted on the veins stimulating venous issues.
- Prolonged standing – The volume and pressure of blood in the lower limbs are affected by gravity, therefore, the longer you stand, the greater the effects.
- Physical trauma – Trauma to the lower limbs can damage the underlying blood vessels adding to the problem of varicose veins.
Central Texas Heart Center – Information and treatment options for heart problems.
VNUS – Learn more about the VNUS Closure procedure technologies, the ClosureFAST catheter, that treats the underlying causes of varicose veins.
1 Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure) versus ligation and stripping in a selected patient population (EVOLVES study). J Vasc Surg 2003;38:207-14.
2 Goldman, H. Closure of the greater saphenous vein with endo radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatology Surg 2000; 26:452-456.
3 Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg 2002;35:1190-6.
4&7 Weiss RA, et al. Controlled Radiofrequency Endovenous Occlusion Using a Unique Radiofrequency Catheter Under Duplex Guidance to Eliminate Saphenous Varicose Vein Reflux: A 2-Year Follow-up, Dermatologic Surgery, Jan 2002; 28:1: 38-42
5 Whiteley, MS, Holstock JM, Price BA, Scott MJ, Gallagher TM. Radiofrequency Ablation of Refluxing Great Saphenous Systems, Giacomini Veins, and Incompetent Perforating Veins using VNUS Closure and TRLOP technique. Abstract from Journal of Endovascular Therapy 2003; 10:I-46.
6 Pichot O, Sessa C, Chandler JG, Nuta M, Perrin M. Role of duplex imaging in endovenous obliteration for primary venous insufficiency. J. Endovasc Ther 2000;7:451-9.