Freeman Medical Musings Blog


Varicose Veins: Newest Treatment for an Age-Old Problem

Posted by Dr. Joseph Newman, on January 09, 2015

Varicose veins are the seemingly unsightly, swollen, twisted and bulging veins found on the legs. They are caused by blood pooling up in the vein when a defective or damaged valve no longer pushes blood back up to the heart. Developing these veins may be more than just a cosmetic issue.

Here's why. Pain, swelling and leg fatigue can readily discourage an active lifestyle. Severe cases can even cause chronic infections and skin ulcerations. Gender, family history, age, pregnancy, obesity and prolonged standing all contribute to this condition.

For many seniors, varicose veins are an unfortunate rite of passage. Nearly 50% of all Americans over the age of 50 and 2 in 3 women over 60 suffer from them, but it’s a common problem at any age. I have treated patients younger than 20 and older than 90.

Hippocrates and the ancient Egyptians wrote about the condition, and until the 21st century, the only surgical treatment was stripping the greater saphenous vein (the primary leg vein). This was a painful, even barbaric procedure requiring a general anesthetic and weeks of recovery. Understandably, most patients avoided this treatment. I still see many patients who have suffered for decades, believing that vein stripping was their only alternative. These same patients are delighted to discover that medical technology has finally caught up with the treatment of varicose veins. Now, we are able to offer a minimally-invasive procedure that treats the condition in minutes.

Breakthroughs in catheter technology, the same type as used for heart interventions, provide physicians with a safe and effective solution in treating varicose veins. Using a local anesthetic, the doctor threads a catheter, about the thickness of a spaghetti noodle, into the vein, heating it from within and sealing it off. The catheter is pulled through the vein using radiofrequency energy (RFE) or laser to heat the vein walls, causing them to collapse inward. Once the vein is sealed, the body automatically re-routes blood through healthier vessels, thus restoring normal circulation. Varicosity symptoms quickly dissipate and the sealed vein is absorbed by the body.

Considered a medical necessity, not cosmetic surgery, this procedure is generally covered by Medicare and most insurers, thus clearing away the final barrier to longtime varicose vein sufferers seeking treatment. We are seeing many new patients.

No longer considered unmanly, we are treating more men than ever before. We’ve seen a rush of interest from active seniors well into their 80s. Many of these have middle-aged children who’ve undergone the treatment, and upon seeing the results, want the treatment for themselves. I’ve had patients tell me they are wearing shorts for the first time in 40 years!