If you experience discomfort, swelling and varicose veins in your legs, you may be suffering from superficial venous reflux disease. Traditionally patients diagnosed with venous reflux would undergo varicose vein stripping surgery. Now, patients can be treated with the Closure procedure—a minimally invasive alternative to painful vein stripping surgery.
The closure procedure can be performed on an outpatient basis using local anesthesia in which the physician numbs the leg before treatment. This procedure can be done in our office, allowing the patient to avoid an inpatient hospital stay. The procedure consists of four principal steps.
Map the Saphenous Vein
A typical procedure begins with noninvasive ultrasound imaging of the varicose vein to trace its location. This allows the physician to determine the site where the Closure catheter will be inserted and to mark the desired position of the catheter tip to begin treatment.
Insert the Closure Catheter
After the physician accesses the saphenous vein, the Closure catheter is inserted into the vein and advanced to the uppermost segment of the vein. The physician then typically injects a volume of dilute anesthetic fluid into the area surrounding the vein. This numbs the leg,
helps squeeze blood out of the vein and provides a fluid layer outside the vein to protect surrounding tissue from heat once the catheter starts delivering RF energy. Saline is then slowly infused into the vein from the tip of the catheter to further create a near-bloodless field inside the vein, allowing the catheter to preferentially heat the vein wall, rather than the blood.
Deliver RF Energy and Withdraw Catheter
Noninvasive ultrasound is used to confirm the catheter tip position and the physician then activates the RF generator, causing the electrodes at the tip of the catheter to heat the vein wall to a target temperature of typically 85 degrees Centigrade or 185 degrees Fahrenheit. As the vein wall is heated, the vein shrinks and the catheter is gradually withdrawn. During catheter pullback, which typically occurs over 15 to 18 minutes, the RF generator regularly adjusts the power level to maintain target temperature to effectively shrink collagen in the vein wall and close the vein over an extended length.
Confirm Closing of Vein
After treatment, ultrasound imaging is used to confirm closing of the vein. If a portion of the vein is not closed, the catheter can be reinserted and energy reapplied. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. This procedure is often completed the in 45 to 60 minutes.
Please call our office if you have any additional questions or would like more information about venous Closure.