The Pain of Varicose Veins
By Zineb Marchoudi
Beth Israel Deaconess Medical Center staff
Varicose veins can be an unsightly problem for both men and women, but for 35-year-old Erin it was turning into more than just a cosmetic issue.
"The veins would be bulging and my ankle would be really swollen," says Erin, who began feeling the discomfort after long hours on her feet working as a nurse.
Some 24 million Americans have varicose veins, which are caused when valves in the veins become damaged and blood flows in the wrong direction.
About 72 percent of all women and 42 percent of men will have leg bulges by the time they reach their 60s.
For Erin, the bulging veins were caused by a congenital abnormality in her right leg that resulted in weaker vein walls.
"You could always see the vein in my leg. I didn't have the superficial fat that would normally hide it," she says.
Erin tried compression stockings but when the pain started setting in, she knew that things would only get worse due to the standing required for her job. Surgery was not an option she was willing to consider.
"I work in the recovery room at the hospital and I've seen how long it takes some patients to recover from surgery," says Erin, who also had hesitations about being under general anesthesia.
Then she learned about a minimally invasive treatment option called the VNUS Closure, now called Veinfit.
"One way to describe the procedure is like closing a Ziploc bag," says Dr. Allen Hamdan, a vascular surgeon at the Cardiovascular Institute at Beth Israel Deaconess Medical Center. "You're taking the vein, which has blood flow in the wrong direction, and putting the two walls of the vein together from top to bottom."
Veinfit replaces the surgical stripping procedure which requires incisions and, usually, general anesthesia. Additionally, the American Venous Forum's national recommendations include complete replacement of surgical stripping by the minimally invasive catheter procedure except in a few circumstances.
The procedure works by inserting a catheter into the greater saphenous vein, the main superficial vein in the thigh and calf. The catheter makes contact with the vein walls. Radiofrequency energy heats the vein walls as the catheter is pulled back and the vein is closed.
Dr. Hamdan says while there is certainly a cosmetic benefit, this procedure is done to treat symptoms. Candidates for the procedure need to have greater saphenous vein reflux, which means blood is flowing in the wrong direction in the saphenous vein. Candidates should also have bulging veins and some pain in the legs.
"Since this is not considered a health worry across the country, a lot of patients don't even realize they're having symptoms," Dr. Hamdan says. "It's not just pain in the veins, it can be a burning, itching sensation or a heavy, tired sensation."
The procedure is done under local anesthesia and takes about 15 minutes; with prep time and short recovery, patients are on their way home in less than an hour. The leg is wrapped in an ace bandage and patients can resume normal activity the next day. When medically necessary, it is covered by most insurance. Patients who have the characteristic symptoms should be evaluated by their doctor to discuss possible treatment options.
"The procedure itself was unbelievable," Erin says. "They gave me a sedative to relax me. It was seriously 45 minutes."
Erin says the pain in her leg is gone. She has also seen significant improvement with swelling and appearance that is only getting better with time.
"Because the bulges in my leg were so bad, I didn't think it would help the way they looked," she says, "But now that it has I think, 'Oh, I think I'll wear a skirt.'"
Whereas before Erin would end her work day having to keep her leg elevated, now she can get through the long shifts without having to sit down all the time.
"I can get through the day and not notice it at all," she says.
Above content provided Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2014