Varicose veins are usually caused by leaky valves in the saphenous veins of the leg that prevent the blood from flowing back up to the heart. Over time, the veins bulge and are often painful. Some of those at highest risk include pregnant women, chefs, nurses, waitresses, hairdressers, and others whose jobs require prolonged sitting or standing.
An estimated 25 million Americans, mostly women, suffer from varicose veins, and 30-something Deborah Heine was one of them. As soon as the Santa Monica mother of three would wake up each morning, she'd complain, "My feet are killing me!"
After her baby was born last year, she'd tried running to get back into shape but had to stop because her feet—which ached constantly—hurt even more when she exercised.
Phillip Levin, M.D., a surgeon at Cedars-Sinai, is one of the first vascular surgeons in Southern California to use a new, next-generation radiofrequency catheter called the VNUS ClosureFASTTM ablation catheter to treat varicose veins.
"The operating time with the new catheter is less than half of what it was with the earlier generation catheter," said Dr. Levin who is considered an expert in the VNUS closure procedure, having treated approximately 300 patients since 2003 with the ClosureFASTTM catheter's predecessor. "Operating time with the previous catheter could take as long as 45 minutes to an hour. The same procedure now takes 15 to 20 minutes to complete and the 98 percent success rate is the same."
The new catheter allows the surgeon to treat the vein in seven-centimeter segments without having to withdraw and reposition it between segments, making the procedure less labor intensive for the surgeon. Patients are usually discharged from the hospital's outpatient surgery center the same day, says Dr. Levin.
During the procedure, Dr. Levin inserts a small catheter into the saphenous vein via a needle stick under ultrasound guidance. The catheter delivers radiofrequency heat to the vein wall, causing it to shrink and close. Once the vein collapses, blood is re-routed to other healthy veins. Usually, no stitches are needed.
After the procedure is completed, Dr. Levin wraps the patient's leg in a thick ace-type bandage that needs to be worn for two to three days. As soon as the patient recovers from the IV sedation, they're cleared to leave the hospital. Some return to work the same day—the only restriction they're given is to avoid running or bouncing for about 10 days.
Previous treatments for varicose veins, such as "stripping," required general anesthesia, an extended hospital stay, a lengthy recovery, and significant swelling, bruising, and pain. Patients treated with the VNUS ClosureFASTTM catheter report minimal pain and bruising.
Heine recovered so quickly that her husband was able to leave on an overseas trip three days after her treatment, leaving her alone to care for their children, ages 6, 3, and 1.
"When I saw Dr. Levin for a follow-up appointment 10 days after my procedure, I'd already recommended the treatment to two other people," she said. "It was a no-brainer. It had made an overnight difference in how I feel."
Sixty-five year old Joe Patterson of Pacific Palisades agrees. He had noticed some discoloration in his ankle area but, unlike Heine, had not experienced any pain in his leg. A six-handicap duffer, Patterson was golfing one day with a retired plastic surgeon who noticed the discolored area on his ankle and suggested he make an appointment to see a physician for an evaluation. An ultrasound revealed that Patterson was developing stasis dermatitis (a skin inflammation) as a result of the varicose vein on his inner lower calf and ankle.
"I was shocked at how quickly I recovered," Patterson, a self-employed investment adviser, said. "I was on the phone with my office as soon as I got home from the hospital. I've had more discomfort after a dental appointment than I had after this procedure."