Frequently Asked Questions

The VNUS Closure™ Procedure

How does it work to treat superficial venous reflux?

Since valves can’t be repaired, the only alternative is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. The Closure procedure provides a less invasive alternative to vein stripping by simply closing the problem vein instead. Once the diseased vein is closed, other healthy veins take over and empty blood from your legs.

How is the Closure procedure different from vein stripping?

During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein, after which a stripper tool is threaded through the saphenous vein and used to pull the vein out of your leg through a second incision just above your calf.

In the Closure procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special (Closure) 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 the Closure procedure is performed on an outpatient basis, typically using local anesthesia.

Three randomized trials of the Closure procedure vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, the Closure procedure was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the Closure procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, Closure patients returned to work 7.7 days sooner than surgical patients. Patients treated with the Closure procedure had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.1

How long does the Closure procedure take?

The Closure procedure typically takes about 15-20 minutes, though patients normally spend 45-60 minutes at the medical facility due to normal pre- and post-treatment procedures.

Is the Closure procedure painful?

Patients report feeling little, if any, pain during the Closure procedure. Dr. Markovitz will give you a local anesthetic to numb the treatment area.

Will the procedure require any anesthesia?

The Closure procedure is performed under local anesthesia.

How quickly after treatment can I return to normal activities?

Many patients can resume normal activities immediately.

How soon after treatment will my symptoms improve?

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

 

VeinGogh™ Ohmic Thermolysis

Who is a candidate for VeinGogh?

Any adult man or woman in good general health who has thin spider veins, or tangled, thread-like veins known as “telangiectasia,” and who is looking for a quick procedure with no downtime, can be an excellent candidate for the VeinGogh procedure.

What areas does VeinGogh improve?

VeinGogh is ideally suited to treat spider veins wherever they may occur, even in delicate areas where other treatments may not be suitable. Areas that can be treated include:
• Legs
• Arms
• Ankles
• Knees
• Face

How is the procedure performed?

After cleaning the injection site, your VeinGogh specialist will use a very fine, insulated needle to administer the treatment just beneath the surface of the skin but without piercing the vessel itself. Tiny vessels will be destroyed and dissappear quickly. Most procedures take less than 20 minutes to perform, and no bandages are required following the procedure

What is the recovery like?

There is no downtime associated with the VeinGogh procedure. Men and women treated with VeinGogh can resume their normal activities immediately after their procedure. In addition, no bandages are required.

When will I begin to see results?

With the VeinGogh system, you will see results immediately following your treatment, as tiny veins close and begin to disappear. Results will continue to improve over the next few days following your procedure. Results may take two or three weeks to appear for treatments of spider veins on the legs.

What will the long-term results be like?

Treatment of spider veins with the VeinGogh system is permanent. Once your veins are treated successfully with the VeinGogh system, they will not re-appear.

What are the risks?

There is a very small risk of scarring, although this risk is minimal and much less than the risk associated with other vein procedures.

 

Venous Disease

What causes varicose veins?

Varicose veins are almost always associated with venous reflux. This occurs when the valves in the leg veins don’t work well, and backward blood flow causes pooling in the lower leg. Without treatment, the pressure this creates may increase over time and cause additional varicose veins and symptoms. People with a family history and who are older, obese or are pregnant may be at increased risk of developing varicose veins.

Can varicose veins be prevented?

It is unclear if varicose veins can be prevented, but certain actions may help limit the disease’s progression and symptoms. Routine exercise, maintaining a normal weight, avoiding excessively long periods of standing or sitting, and the use of compression stockings may all help alleviate symptoms.

What happens if I don’t treat the vein?

If you have underlying venous disease (e.g., venous reflux), the pressure created by backflow of blood and pooling in the lower legs may create a progressive condition that only gets worse with time. This may lead to additional spider veins and varicose veins, and in some cases can lead to swelling and venous ulcers at the lower calf and ankle. Only a trained vein specialist can effectively evaluate your spider veins or varicose veins.

Will my spider veins or varicose veins reoccur, even with treatment?

Sometimes the same factors that helped to cause your first spider veins or varicose veins (e.g., family history, age, obesity, female hormones, etc.) will make you predisposed to develop additional vein conditions. If a specific vein is properly treated, it usually does not recur, but it is possible that other veins may become diseased. This is why it is important that even if you have what appear to be simple, cosmetic spider veins, that you consult a vein specialist who can determine if you have an underlying condition (venous reflux). If you do, and you don’t treat the cause of the problem, additional spider veins or varicose veins are likely to develop.

Won’t I need that vein?

Procedures like sclerotherapy, EVLT and Closure act to close down a faulty vein. The vein being closed is dysfunctional and is allowing blood to flow backwards and pool, so leaving it open only makes things worse. The body contains numerous other healthy veins that are still functional and can easily take up the additional flow. Treatment of the faulty veins almost always results in improved blood flow in the overall vein system.

What is the cost of vein treatment?

Procedures like EVLT, Closure and vein stripping, when shown to be medically necessary, are commonly covered by Medicare and insurance providers. Sclerotherapy for spider veins is generally considered a cosmetic procedure and usually not covered. Consult your local insurance provider to determine your exact eligibility and coverage as well as cost.

Which doctors treat varicose veins?

There is a newer physician specialty called phlebology which focuses on vein treatment. This specialty has its own society (American College of Phlebology), provides board certification and specialty training. Consult with your individual physician to determine whether they have any such specialty training or certification.