A new treatment for unsightly and painful varicose veins uses an adhesive to cut off blood supply without surgery.
The VenaSeal closure system differs from procedures that use drugs, lasers, radio waves, or surgical cuts. Once injected through a catheter, the adhesive, or glue, solidifies, cutting off blood supply to your vein, effectively making it disappear from sight.
About 30 to 40 million Americans have varicose veins, which are caused by the failure of a valve in a vein that creates “reflux,” flow of blood down your leg rather than upwards towards your heart.
Veins and arteries are the expressways for blood flow throughout the body. Arteries carry blood away from the heart and, in general, contain freshly oxygenated blood that is circulated via smaller and smaller blood vessels to body tissues.
Veins carry low-oxygen blood back to the heart. To prevent backflow, since blood in the veins is under low pressure, veins have valves that also help blood return to the heart.
If you have varicose veins, which occur mainly in the legs, it’s because those valves malfunction, allowing the veins to become engorged with blood. You know them when you see them; bulging, blue, and twisted.
Left untreated, varicose veins can worsen over time, causing aching, fatigue, and skin changes such as rashes, redness, and sores, says the Society for Vascular Surgery (SVS).
“You have three kinds of veins in your legs: the superficial veins, which lie closest to your skin, the deep veins, which lie in groups of muscles, and perforating veins, which connect the superficial veins to the deep veins,” the SVS says. “The deep veins lead to the vena cava, your body's largest vein, which runs directly to your heart. Varicose veins occur in the superficial veins in your legs.
Those veins can be sealed up to stop blood flow, or removed, so that other veins in your legs pick up the slack in returning blood to your heart to be re-oxygenated. The sealed veins eventually dissolve back into your body.
Although some varicose veins can cause aching, the majority don’t present symptoms, and treatment is typically for cosmetic reasons, not reimbursable by insurance. A variety of treatments are available. They include laser treatment, surgical stripping, and injections of liquid or foam agents, or injection of adhesives.
No consistently superior results are achieved using one injection technique versus the other (including glues), but laser is somewhat less effective. Treatment is not without risk, such as ulceration, pain, blood clots, and allergic reaction. In many cases, the dark color of the superficial vein will lighten up but not completely disappear.
Approved by the Food and Drug Administration (FDA) in 2015, the VenaSeal system is the latest in procedures developed to help you avoid the surgical removal of varicose veins. Others have included the EVLT laser, which seals your varicose vein after the injection of an anesthetic to numb the feeling of intense heat close to the skin. In this procedure, the doctor can apply a topical anesthetic cream to your skin, or your skin can be cooled beforehand if you may be afraid of needles – and many people are. Studies show that laser ablation is an effective method for needlephobes.
Other non-surgical techniques you might want to try include Clarivein and the Sapheon Glue system. Clarivein employs the combination of a drug and a mechanical rotator; the Sapheon system is a type of “superglue” that sticks your vein walls together.
“With every new technique a prolonged period of evaluation is needed to test the results,” says vascular surgeon Eddie Chaloner.
As the first surgeon to use the Clarivein method in the UK, Chaloner says he has been able to evaluate the technique over several years of follow up in more than 200 patients.
He adds that results have been “stunningly good.” But the re- occurrence rate of other varicose veins has been higher than when lasers are used. He believes that may be related to the damage the technique does to the vein wall.
Speaking about the VeniSeal system, an FDA official, William Maisel, MD, says, “it’s the first to permanently treat varicose veins by sealing them with an adhesive.”
“Because the VenaSeal system does not incorporate heat application or cutting, the in-office procedure can allow patients to quickly return to their normal activities, with less bruising,” says Maisel, acting director of the Office of Device Evaluation in the FDA’s Center for Devices and Radiological Health.
It’s worth noting that while new treatments like Venaseal can eliminate varicose veins painlessly and quickly, they can’t keep them from forming. That’s where you and your lifestyle come in.
Lifestyle changes often are the first treatment for varicose veins, says the National Heart Lung and Blood Institute (NHLBI). According to the NHLBI, lifestyle changes can include avoiding standing or sitting for long period of time without taking a break and not crossing your legs. You should also try to keep your legs raised when sitting, resting, or sleeping, preferably above the level of your heart. If your job requires you to stand for long periods of time use compression hose stockings. You can reduce your risk of varicose veins, and your legs will feel less tired by the end of the day.
Physical activity to get your legs moving and improve muscle tone is also a must since it helps move blood through your veins. In addition, if you’re overweight, you should try to lose some pounds to improve blood flow and ease the pressure on your veins.
Avoid wearing tight clothes, “especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse,” the NHLBI says.
Women shouldn’t wear high heels for long periods of time. Lower heeled shoes can help tone your calf muscles and that, in turn, helps blood move through the veins.
There are now plenty of ways to have varicose veins treated and just as many to help prevent them, so get those bathing suits and shorts ready for the next summer season.
February 05, 2016
Christopher Nystuen, MD, MBA