Closing Veins

Results with Catheter-Based Method As Good As Surgery, Doctors Say

Varicose veins are caused by a pooling of blood in the major leg vein, called the saphenous vein, which appears purple and mottled in sufferers. Click here to find out how a new procedure helps remove them--------- By Ani Setrakian B O S T O N, March 30 Sufferers of varicose veins have a new option for getting rid of the enlarged and sometimes painful blood vessels on their legs. Called Closure, it is an outpatient and minimally invasive procedure that shrinks the veins through the use of an inserted catheter and radio frequency energy that helps collapses the vein. The new method is an alternative to the current method to eliminate varicose veins, known as stripping, an operation that actually extracts the vein. Approximately 150,000 such surgeries are performed each year in the United States.

Poor Valves, Weak Walls

Varicose veins are caused by a pooling of blood in the major leg vein, called the saphenous vein, which appears purple and mottled in sufferers. Problems in the valves that control the flow of blood or weakness in the walls of the vessel cause the irregular vessel. Although this condition is not life threatening it can be extremely painful and can infringe on a persons quality of life due to the pressure, swelling and tenderness of the superficial vein, doctors say. The new treatment, called Closure provides the same benefits as surgery without a highly invasive procedure, according Dr. Mark Marzano, an interventional radiologist at the Vein Care Associates, in Barrington, Ill.

As Good As Surgery

Marzano presented results of his work with this method on approximately 300 patients at the meeting of the Society of Cardiovascular and Interventional Radiology, being held this week in San Diego, Calif. The 45-minute procedure is done on an outpatient basis with local anesthesia. A physician makes a small incision at the patients knee and inserts a slender catheter into the saphenous vein. Inside the catheter are electrodes, which radio-frequency energy heats. The warmth stimulates the vein to collapse. Vnus Medical Technologies of Sunnyvale, Calif., sells the Closure, device, which includes a $20,000 generator for the radio waves and a $725 disposable catheter, to doctors. The Food and Drug Administration approved the method in March 1999.

Follow-up Data Coming

According to Doug Petty, Vnus marketing manager, the device has not caught on, to date, because doctors have been waiting for follow-up clinical data, which has only recently become available. But Marzano says Closure is as effective as the stripping, which involves surgically tying off the saphenous vein and pulling it out through an incision in the knee. The standard procedure also calls for general anesthesia, Marzano says, which often frightens patients and convinces them to continue living with the uncomfortable and unsightly veins. Marzano says Closure is 95 percent effective in shrinking varicose veins and patients can go back to work the next day. Some members of the medical community remain skeptical of the long-term effects of the Closure. Dr. Peter Lawrence, professor of surgery at the University of California at Irvine, is concerned varicose veins may reoccur after the procedure. Not every one is a candidate for Closure. Patients with pacemakers, internal defibrillators, and aneurysms in a section of the varicose vein are not suitable. Complications are similar to those of other venous procedures: If done improperly, clotting may occur in the surrounding veins. SEARCH ABCNEWS.com FOR MORE ON W E B L I N K GO Varicose Vein Links