FAQ

The following are important Frequently Asked Questions relative to the current medical practice of treating venous reflux disease with the favored Closure procedure and other techniques as used by Vein Centers at NYC Surgical Associates:

What is the primary cause of varicose veins?

With the aid of the muscles in the leg, both major and secondary leg veins act as direct streams for transporting blood back to the heart. Each vein has many valves to aid in directing the blood flow. When these valves malfunction, the blood flow returns to the leg, causing such medical conditions as venous reflux. The leg veins begin to swell and are transformed into varicose veins. Especially when there is valve damage in the saphenous vein leading to the groin area, blood flow reversal channels blood back into the leg’s smaller surface veins.

What exactly are varicose veins?

Typically, varicose veins are enlarged blue colored veins that are positioned near the skin’s surface and have become twisted. Because vein valves have incurred damage, blood contained in these veins is under increased pressure. Such added pressure and stress cause blood flow into nearby tissue, resulting in a swollen, heavy leg. Without proper treatment, varicose veins can be the cause of swollen ankles and feet and prolonged itching of the skin surface. These enlarged veins can also cause venous ulceration.

What are the major symptoms of varicose veins, and why are they found mainly in the legs?

In addition to swollen ankles and feet, varicose veins can cause pain in the legs, especially during the heat of summer or in warm climates. These veins may suffer inflammation or even become ulcerated. If sections of the lower leg develop deadened skin and open flesh, ulcerations may result. These ulcers may be smaller than a coin or stretch completely around the leg. They may release fluid and cause extreme discomfort, enduring for months or at worst, years. These ulcerations are found mostly among older patients.

This vein disorder commonly occurs in the legs due to gravitational pull and the fact that the route from the heart to the feet and back again is the longest cycle the body’s blood flow is required to make within the body. If the internal pressure is too great for the venous valves, reversal of blood flow direction can inflict swelling and discomfort in the veins near the leg surface.

Who is most likely to develop varicose veins?

Greater numbers of women develop varicose veins than men, and as many as 50% of the population over the age of 50 suffer from this condition. It is estimated that between 10% and 20% of all adults will develop symptoms of varicose veins sometime during their lives. A person’s susceptibility to developing this venous disorder is generally increased when obese or pregnant, and genetics along with changes in bodily hormone levels can also play important roles in the individual’s likelihood of having varicose veins. People who have suffered from thrombophlebitis, or inflamed veins as the result of blood clot occurrence, may develop varicose veins more easily than others. Also, people who are on their feet for prolonged periods of time are often susceptible to varicose vein problems.

Is there a short-term treatment for varicose vein symptoms?

Basic signs and symptoms of varicose veins can be somewhat lessened by the generally prescribed and accepted “Exercise Stockings Elevation and Still” (ESES) technique. By exercising and wearing supportive stockings on a regular schedule, leg discomfort can be alleviated to some degree. In addition, resting the legs in an elevated position and maintaining your recommended weight will help prevent your legs from becoming swollen, sensitive and overly tired or cramped. More serious treatments like sclerotherapy and phlebectomy are available for varicose veins that are pronounced in severity or clearly visible.

What do sclerotherapy and phlebectomy treatments involve?

Sclerotherapy is most often used to treat surface veins which are small. Patients are treated with an injection of a detergent or saline type liquid directly into the affected vein. This vein will then begin to spasm and eventually close, letting surrounding veins assume its functions. It is good to remember, however, that very often varicose veins recur, so this treatment method is seen as a temporary measure to relieve patient discomfort. More serious treatment is needed to affect the venous disease causing these symptoms, venous reflux.

Phlebectomy surgery is performed as an ambulatory procedure and used mainly on surface or superficial veins. In this surgery, a varicose vein is removed from the leg with forceps or hooks, usually with the aid of local or treatment area anesthesia.

What is the difference between vein stripping and Closure?

Vein stripping is used to alleviate varicose veins when damaged valves are found in the saphenous vein. General anesthesia is used while a section or the entirety of the affected vein is either removed or tied off. In vein stripping, the first surgical incision is made in the groin for vein tying. Then, by means of a stripper implement inserted through the saphenous vein, the affected vein can be removed from the leg at an incision point above the leg calf.

When the Closure method is employed, the vein is closed with a catheter placed into the vein by means of a small puncture opening. Closure is often used to treat the same condition, but does not require removal of the affected vein. Also, it can be undertaken without use of general anesthesia. Unpleasant effects resulting may be paresthesia (numbness or a tingling sensation), blood clots, exaggerated sensitivity and burning of the skin.

How do veins differ from arteries?

The basic difference in veins and arteries is that while arteries are responsible for pumping healthy blood out from the heart, veins redirect blood which is low in oxygen levels back into the heart. There are actually three major subtypes of veins: (1) Deep leg veins that send blood back to the heart. They are located in the central leg close to the bones; (2) Superficial (surface) veins that lie directly under the leg skin. Their walls often weaken and swell, forming varicose veins; (3) Perforator veins that connect the surface vein structure with the deep vein blueprint.

How does the Closure method successfully treat venous reflux?

The Closure surgical method is less invasive than the vein stripping procedure. By closing the diseased vein, surgeons cause other more active and effective leg veins to assume its former function of directing blood in the leg back toward the heart. There is no current procedure for repairing faulty valves. Therefore, the best way to enhance healthy blood flow from the legs is to redirect its movement via other high functioning veins. The majority of patients undergoing Closure treatment had few adverse effects and returned to normal activity levels after one day’s rest.

How long does the Closure surgery take and is it painful?

Although most patients undergo approximately 30 minutes of pre- and post-procedural routine, the actual Closure surgery takes only around five minutes to perform. With the aid of a regional, local or general anesthesia during the treatment, most patients do not experience pain. Your doctor will most likely suggest that you not undertake any stressful activity or long periods of standing for a few weeks after your Closure procedure to avoid any pain or discomfort. Fortunately, the majority of patients have very little, if any, scars, bruises or noticeable swelling following this procedure.

What are the possible risks of the Closure surgical procedure, and is patient age an issue?

Large numbers of patients of various ages having superficial venous reflux disease have proven to be good candidates for the Closure surgical method. However, there are some potential complications and risks associated with this procedure, including thrombosis, vessel perforation, hematoma and pulmonary embolism.

What is the fate of the vein in the leg that was medically treated by the Closure procedure?

Following the Closure procedure, the vein treated is transformed into fibrous tissue in the body. This vein will slowly merge with closely surrounding tissue.

Will my insurance plan cover the Closure procedure?

Be sure to discuss your insurance plan coverage relative to this procedure with your physician ahead of time. Many health insurance carriers now offer coverage for the VNUS, which is currently awarded good health insurance coverage through most major insurance plans.

How will a successful Closure surgical procedure on my leg impact my overall health?

With increased rates of blood circulation in the body, your overall health should benefit as a secondary, but very important, aspect of this venous treatment.

As a successful, popular modern procedure for treatment of venous reflux and other similar conditions related to varicose veins, the Closure surgical procedure works medical wonders as it continues to raise the level of blood flow and overall internal organ functioning for increasing numbers of patients each day. This state-of-the-art medical procedure is highly recommended by Vein Centers at NYC Surgical Associates for excellent treatment of venous reflux disease and its symptoms.