Varicose veins are an old problem – Hippocrates and the ancient Egyptians wrote about them – and for many seniors, they are an unfortunate rite of passage. Half of all Americans over 50, and two-thirds of women over 60, suffer from those big ropey leg veins. The problem is far more than cosmetic – the pain, swelling and leg fatigue can really discourage an active lifestyle, and severe varicose veins can even cause chronic infections and skin ulcerations.
Memorial—Lufkin and its new Cardiothoracic and Vascular Surgeon, Dr. David Ladden, are introducing breakthrough technology that is successfully treating varicose veins in a matter of minutes. “In the dark ages before the 21st Century, the only surgical treatment was stripping out the saphenous vein, a painful and barbaric procedure that required a general anesthetic and weeks of recovery,” said Dr. Ladden. “Needless to say, most patients avoided that operation if they could, and I still see lots of patients who have been suffering for decades and thought vein stripping was the only alternative. They are delighted to find out that medical technology has finally caught up with varicose veins, and we now have minimally-invasive procedures that can deal with the problem in minutes.”
According to Dr. Ladden, varicose veins generally occur when the valves fail in the primary leg vein, which is called the greater saphenous. Those valves are supposed to push blood back up towards the heart, but when they can not do the job anymore, the blood pools up in the veins. Women with more than two children and people who work on their feet like nurses and teachers are particularly at risk, and heredity and obesity are also factors. “It is a pretty common problem – I have seen patients younger than 30 and older than 90,” said Dr. Ladden.
Dr. Ladden says the breakthrough is catheter technology, the same kind that is used for heart interventions. “Under a local anesthetic, we thread a catheter, about the thickness of a spaghetti noodle, into the vein to heat it from within and seal it off, rather than removing it. The doctor pulls the device through the vein, using either radiofrequency (RF) energy or laser to heat the vein walls and cause them to collapse inward on themselves. Once the vein is sealed, the body automatically re-routes blood flow through healthier vessels and normal circulation is restored. The varicosity symptoms quickly dissipate.”
“The speed and comfort of this technique are amazing to my patients,” said Dr. Ladden. The device, VNUS® ClosureFAST™, uses radiofrequency energy to seal a typical 45-centimeter length of vein (about 14 inches) in three to five minutes. The only discomfort the patient feels is a couple of needle sticks. Patients are encouraged to get up and walk immediately after the procedure, with most returning to normal activity the very next day. The pain and fatigue disappear almost instantly, and the swollen veins begin to deflate in a week or two.
Dr. Ladden says he prefers the RF device to the older laser catheters because the lasers operate at extremely high temperatures – over 800 degrees Fahrenheit – and that can be traumatic to the tissues, causing pain and bruising. RF operates at much lower temperatures and it’s far more comfortable for the patient.
This procedure is considered a medical necessity, rather than cosmetic surgery, so it is covered by Medicare and most insurers. That clears away the one final barrier to longtime varicose vein sufferers seeking treatment. More men than ever before are requesting the procedure – having one’s varicose veins treated is no longer considered unmanly. And there has been significant interest in the technology from active seniors in their 70s and 80s – their middle-aged children are undergoing the procedure, and when the parents see the results, they want the treatment themselves. “I have had patients tell me they are wearing shorts for the first time in 40 years,” said Dr. Ladden.