A saphenous vein runs up the leg from ankle to groin. Its job is to help return oxygen-depleted blood to the heart. In some, this vessel functions properly. However, if the valves (which are designed to prevent blood from flowing backwards) in the saphenous vein don’t function properly—a condition called superficial venous reflux—numerous problems occur. Symptoms can include swelling, pain, fatigue and varicose veins.
Varicose veins are known for their distinctive blue color and bulging appearance on the skin. Resembling large, elongated worms, they afflict an estimated 10%-20% of the adult population. In the United States, that translates into 20-25 million people.
Whether the initial cause is genetics, pregnancy, prolonged standing, 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 (or incompetent valves) in the saphenous vein is often the underlying cause of varicose veins.
Although this condition is rarely life threatening, it is often painful and unattractive.
Historically, patients have had a couple 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 reducing symptoms, but only as long as the hose are worn consistently. There is no evidence that wearing support hose prevents further deterioration of the vein. 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 “micro-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 a variety of specialized surgical instruments. However, phlebectomy alone does not address the incompetent valves in the saphenous vein which created the problem and can cause varicose veins to recur.
Some physicians thus advocate the removal of, or stripping, the saphenous vein. This typically causes significant bruising and can create post-operative pain, nerve damage and poor short-term cosmetic outcomes. So, most good vein doctors do not do stripping
The Closure® System was developed over a four year period to treat superficial venous reflux providing the benefits of stripping without the associated drawbacks, e.g. invasive surgical procedure, general anesthesia, post-operative pain, bruising and prolonged recovery period. This patented technology uses a very small catheter and radiofrequency energy to occlude, or seal shut, the saphenous vein. The Closure procedure is an outpatient technique that is often performed in a physician’s office. There are no stitches and most patients return to normal activity within a day or two.
Recent published studies found that at 12 and 24 months following the Closure procedure, 90% of treated veins remained reflux free and a significant reduction of limb pain, fatigue and edema was observed. In one study that also assessed patient satisfaction at 6 months, 98% of patients indicated they would recommend Closure to a friend with similar leg vein problems.
Like other venous procedures, the Closure procedure involves risks and potential complications. Each patient should consult their doctor to determine whether or not they are a candidate for this procedure, and if their condition presents any special risks. Complications reported in medical literature include numbness or tingling (paresthesia), skin burns, blood clots and temporary tenderness in the treated limb.
“Doctors using the Closure system offer a different view. ‘It’s the best thing available,’ says Nick Morrison, MD. He says he has successfully treated over 4600 people with the Closure method, and he has checked patients up to a year after treatment. Recurrence rates are less than 10%.” Dr Nick Morrison was the first in the southwest United States to perform this procedure.