Twenty-five million Americans have varicose veins. Venous reflux, often the underlying cause of varicose veins, frequently forces people to dramatically change their lifestyles, especially when they have standing professions and can no longer tolerate being on their feet all day.  Whether the initial cause is genetics, pregnancy, prolonged standing, excess weight, inadequate exercise or a damaged saphenous vein, the physiology of varicose veins is nearly always the same.

The valves in the saphenous vein are damaged– physicians call them “incompetent” – and the veins near the skin surface are stretched and distorted from the increased pressure caused by blood flowing in the wrong direction. Venous reflux (caused by incompetent valves) in the saphenous vein is often the underlying cause of varicose veins. Although the condition is rarely life-threatening, it is often painful and unattractive.

The VNUS Closure®procedure is an outpatient (day surgery) treatment now offered at PVCare by Dr. Thomas Parisi, M.D.  The procedure is called Endovascular Catheter Ablation (EVCA), and specifically, Endoluminal RadioFrequency Thermal Heating (VNUS).  By using radiofrequency, or as its more commonly known as ultrasound, the patient experiences less discomfort and has significantly less healing time.

Historically, patients have had several choices for treating varicose veins, depending on the severity. They could make lifestyle changes, such as eating less, exercising more and wearing support hose. This regimen has proven helpful in somewhat reducing leg pain and further deterioration of the vein, particularly in mild cases. But sooner or later most patients return to their previous lifestyles, and thus their previous symptoms typically re-occur.

Patients could also have the visible varicose veins removed in a procedure called "phlebectomy." This surgical technique was developed in the 1950s. A specially trained physician removes diseased veins through a series of very small punctures or incisions with avariety of specialized hooks. However, phlebectomy alone does not address the incompetent valves in the saphenous vein, which is often the cause of the problem and can cause varicose veins to recur.  Dr. Parisi does perform phlebectomy on patients requiring completion of their medical care or in a cosmetic variety.

Some physicians advocate the removal, or stripping, of the saphenous vein. By removing the saphenous vein, blood is diverted to other veins with competent valves. In many cases, stripping eliminates the pain associated with varicose veins and greatly reduces their potential for recurrence without the need for further intervention. Stripping involves making an incision in the groin region and surgically tying off the top of the saphenous vein. An instrument resembling a thin rod with a bulbous end is then inserted into the saphenous vein and passed through to the upper calf. Another incisionis made at the upper calf. The stripping device is then tied to the vein, which is pulled out through the second incision. Recovery after the surgery may last weeks, typically causes significant bruising and can create post-operative pain, nerve damage and poor short-term cosmetic outcomes.  Dr. Parisi does not perform surgical stripping but does revise stripping procedures as well as laser therapy.