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more articles by Ferrer, Guillermo , MD  |  author's bio

Revolutionary New Treatment for Painful Varicose Veins

Revolutionary Treatment for Painful Varicose Veins

By Guillermo Ferrer, MD, FACS


An estimated 20-25 million Americans are afflicted with varicose veins. Regarded by many as merely a cosmetic nuisance, varicose veins can be quite painful and may increase a person’s risk of phlebitis, blood clots, skin ulcers, and permanent scarring.


Prior to 1999, varicose veins were treated with a procedure called “stripping,” which was painful, required general anesthesia and a long postoperative convalescence, and often resulted in scarring of the legs. This procedure is still widely used today.


Today three revolutionary minimally invasive procedures, which are available locally, enable surgeons to perform vein surgery under local anesthesia with minimal downtime and discomfort. Patients can return to normal activities in a matter of days and since there are no large incisions, there is little or no scarring.


What causes varicose veins?


The leading cause of varicose veins is venous reflux disease caused by incompetent or leaky valves in the leg veins that carry blood from the feet and ankles back to the heart. These leaky valves lead to increased pressure in the superficial leg veins, which causes swelling, leg fatigue, varicose veins, and the eventual breakdown of the skin.


What kind of impact can varicose veins have on a person’s quality of life?


Varicose veins can force people to dramatically alter their lifestyles, especially when their work requires long periods of standing on their feet. An estimated two million workdays are lost each year in the United States to this common medical condition. In addition to the physical discomfort, many people with severe varicose veins are very self-conscious about the appearance of their legs. Even on the hottest days of summer they wear long pants, avoiding shorts, skirts, and bathing suits.


What are the new surgical procedures for treating varicose veins and how do they work?


The three new methods in use locally are ambulatory phlebectomy, endo vascular laser treatment (EVLT), and VNUS Radio Frequency Closure.


Ambulatory phlebectomy is microsurgery for treating the largest, most dysfunctional varicose veins, using tiny incisions that do not typically require stitches. This is outpatient surgery performed at Surgicare, Cayuga Medical Center’s ambulatory surgery center located on the Convenient Care Campus.


EVLT is a minimally invasive procedure that uses laser fiber to close the incompetent vein. The fiber is inserted into the vein through a small catheter. Heat emanating from the laser fiber changes the inside walls of the vein, effectively closing it. Over time the closed vein dissolves and is absorbed by the body. The blood originally traveling through the vein is rerouted to the deeper circulatory system.


VNUS closure is an alternative medical technology involving a catheter to deliver radio frequency energy (a form of electrical current). The current shrinks the incompetent vein. As a result, scar tissue forms that obliterates the inside of the vein. Similar to EVLT, the vein dissolves and is absorbed by the body, and the blood is naturally rerouted.


Each of the minimally invasive procedures has pros and cons; your surgeon will make a recommendation about which procedure will work best in your situation. All three of the procedures entail fast recovery times and minimal waiting prior to resuming normal activities.


What if I have ulcers on my legs from varicose veins?


Many patients travel to Ithaca for treatment of ulcers; many of them have been treated elsewhere for the wound but not for the underlying problem causing the ulcer. This happens all too often because not all doctors know about the availability and effectiveness of this treatment.


There is no need today to suffer from varicose veins or to put off treatment because it is painful and scarring. Minimally invasive surgery has changed the way venous disease is treated. It can restore functional, healthy legs and allow you to return to the activities you enjoy most.


Dr. Ferrer is board certified in general surgery, is a Fellow of the American College of Surgeons, and is a Diplomate of the American Board of Phlebology. He serves on the medical staff of Cayuga Medical Center and is in practice at the Vein and Laser Center of Central New York, in Ithaca, at (607) 257-2116. You can visit the Web site at


 Dr. Ferrer graduated with honors from medical school at La Universidad del Zulia in Maracaibo, Venezuela. He completed a five-year general surgery residency program at State University of New York in Brooklyn, where he served as chief resident of trauma in his fourth year and surgery chief resident in his fifth year. He went on for a fellowship in cardiothoracic surgery at Newark Beth Israel Hospital.







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