Revolutionary Treatment for Painful Varicose Veins
By Guillermo Ferrer, MD,
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 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
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
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
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
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
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.
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 www.veinscny.com
graduated with honors from medical school at La Universidad del Zulia in
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