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Treatment of Varicose Veins and
Superficial Venous Insufficiency

By:  Hope Waltman

“Author’s Note:  VNUS Closure, Ambulatory Phlebectomy, and Injection Sclerotherapy are breakthrough procedures for treatment of varicose veins that are superior to surgical techniques which include ligation (tying off the vein) and vein stripping (the removal of a segment of a vein by pulling it out with special instruments).  Radio Frequency (RF) Ablation of varicose veins has been in development over the last ten years.  Dr. Robert Worthington-Kirsch performs VNUS Closure Procedure, Ambulatory Phlebectomy, and Injection Sclerotherapy for varicose veins at Roxborough Memorial Hospital, Philadelphia, Pennsylvania.” 

There are many contributing factors that cause varicose veins to develop:  heredity, hormonal factors such as puberty, pregnancy, birth control pills, estrogen, progesterone, and menopause affect the disease.  Other factors include age, occupations that require a lot of standing, overweight, and leg injury. 

Symptoms can become worse with prolonged standing, fatigue, the legs and ankles can swell, heaviness, aching, burning, throbbing, itching, and cramps.  The disease can lead to eczema, hyperpigmentation, inflammation or even ulceration of the lower leg. 

Spider veins (also known as broken capillaries) are small veins, near the surface of the skin, that appear as small blue, red, or purple veins.   

Varicose veins are caused by damaged or diseased valves, which result in the backward flow of blood in the legs, a condition known as venous reflux.  Venous Reflux causes the veins that are located on the calf or thigh to bulge, swell, and cause pain. 

Dr. Robert Worthington-Kirsch describes the VNUS Closure, Ambulatory Phlebectomy, and Injection Sclerotherapy procedures as follows:  “At the initial office consultation the doctor will interview the patient, take a medical history, and examine the legs.  A non-invasive examination will consist of a Doppler and color Duplex ultrasound.  Photos of the treatment area will be taken at this time. 

VNUS Closure Procedure, which replaces vein-stripping surgery, is an outpatient (day surgery).  Local anesthesia is used to numb the area.  A thin catheter is inserted, through a needle stick in the skin, into the damaged vein.  The catheter selectively delivers radiofrequency (RF) energy to the vein wall, which causes it to collapse and seal shut.  After the diseased vein is sealed, healthy veins will take over and carry blood from the patient’s leg and re-establish normal blood flow. 

The catheter is removed and a bandage or compression hose is placed on the treated leg immediately following the procedure.  Patients resume to normal activities within 1-2 days, and their symptoms improve in 1-2 weeks after the procedure.  There is minimal to no scarring, bruising, or swelling.  This procedure provides durable relief in about 90% of the patients. 

A follow-up appointment will be made to see the doctor a week later to examine the treated vein.  The doctor may decide to have another Doppler and duplex ultrasound image performed and more photos may be taken.             

Ambulatory Phlebectomy is a minimally invasive surgical technique to treat mid-size veins.  A tiny incision is made and the abnormal vein is removed using special tools.  It is done under local anesthesia, and takes under an hour.  Recovery is rapid and there is no interruption to regular activities after this procedure.

Injection Sclerotherapy is used to treat spider veins.  The doctor injects medication into the abnormal vein in order to cause its disappearance.  After the abnormal vein is eliminated, the blood flow is improved.  Injected veins are converted into fibrous tissue that will be absorbed by the body and eliminated as waste.  The advantage of sclerotherapy is the in-office treatment, no anesthesia, minimal discomfort, and little chance of scarring.”   

VNUS Closure, Ambulatory Phlebectomy, and Injection Sclerotherapy appear to be very safe techniques that yield impressive results over the existing surgical varicose vein treatments. 

For more information about Treatment of Varicose Veins and Superficial Venous Insufficiency contact Dr. Robert Worthington-Kirsch, Image Guided Surgery Associates, PC, e-mail kirsch@igsapc.com, website www.IGSAPC.com.

Copyright:  Today's Woman November 2002 issue, Lancaster, Pennsylvania.

(Varicose Vein Patient Information Brochure)

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