A new technique uses radiofrequency
energy to help shrivel varicose veins -- the unsightly, painful bulges that
appear on the legs when blood pools in the veins, researchers report.
People who have undergone the office-based procedure can return to normal
activities almost immediately, rather than after a 3-week recuperation period
that typically follows vein stripping, or surgical removal of the veins,
according to Dr. Mark Marzano, an interventional radiologist with Endovascular
Associates in Barrington, Illinois. Marzano presented the study findings at the
25th Annual Scientific Meeting of the Society of Cardiovascular and
Interventional Radiology, held in San Diego, California.
The procedure also leaves fewer, less noticeable scars than vein stripping.
"It's a more attractive alternative," said Marzano.
In the new technique, a small incision is made behind the knee and a
catheter (a hollow flexible tube) is threaded into the vein. A radiofrequency
probe attached to the catheter releases energy and heat inside the vein, causing
it to shrink and close off.
Since varicose veins are caused by a backflow of blood in the saphenous vein
(the largest vein in the leg) and smaller branch veins, the closure should
remedy the leg fatigue, pain, and itchiness that frequently plague patients.
Larger veins should no longer be a problem, although existing spider veins
(tiny veins close to the skin surface) will not necessarily disappear.
Phlebectomy, a procedure to remove the branch veins, can be done at the same
time as the radiology technique.
Marzano and colleagues conducted a study of 222 patients at 33 centers who
underwent the procedure. The technique was found to be 95% effective (209 of 219
veins were closed). And six months after the procedure, all the veins remained
closed.
In the study, six limbs developed skin burns, but this problem is
potentially avoidable when a salt-water solution is inserted between the vein
and the skin, Marzano explained. There is also a slight risk of blood clots.
Patients are now checked for potential clots within 72 hours of treatment.
The researchers plan to conduct more studies to find how long the effects of
the procedure last. As an alternative to surgery, people with varicose veins can
undergo sclerotherapy, a commonly used technique in which veins are injected
with an irritant to close them off. However, with this technique, the problem
may recur.
With the new technique, unlike vein stripping, there is no permanent
scarring, no need for general anesthetic, no radiation and relatively little
blood loss, Marzano said. "It is far less invasive than traditional vein
stripping," and it is comparable in price.
About 25 centers in the United States now have radiologists who perform this
technique, Marzano noted. The study findings are scheduled to be published in
the Journal of Vascular and Intervention Radiology in the near future.
