The Pain of Varicose Veins
By Zineb Marchoudi
Beth Israel Deaconess Medical Center Staff
Varicose veins can be an unsightly problem for both men and women, but for 35-year-old Erin Tremblay it was turning into more than just a cosmetic issue.
"The veins would be bulging and my ankle would be really swollen," said Tremblay, who began feeling the discomfort after long hours on her feet working as a nurse.
Some 24 million Americans have varicose veins, which are caused when valves in the veins become damaged and blood flows in the wrong direction. About 72 percent of all women and 42 percent of men will have leg bulges by the time they reach their 60s.
For Tremblay, the bulging veins were caused by a congenital abnormality in her right leg that resulted in weaker vein walls.
"You could always see the vein in my leg. I didn't have the superficial fat that would normally hide it," she said.
Tremblay tried compression stockings but when the pain started setting in, she knew she needed to get treatment to avoid more serious problems like blood clots. Surgery was not an option she was willing to consider.
"I work in the recovery room at the hospital and I've seen how long it takes some patients to recover from surgery," said Tremblay, who also had hesitations about being under general anesthesia.
Then she learned about a new minimally invasive treatment option called the Venous Closure.
"The way some people have described it is like closing a ziploc bag," says
Dr. Allen Hamdan, a vascular surgeon at the
Cardiovascular Institute at
Beth Israel Deaconess Medical Center. "You're taking the vein, which has blood flow in the wrong direction, and putting the two walls of the vein together from top to bottom."
The procedure works by inserting a catheter into the greater saphenous vein, the main superficial vein in the thigh and calf. The catheter has electrodes that deploy and make contact with the vein walls. Radiofrequency energy heats the vein walls as the catheter is pulled back and the vein is closed.
Dr. Hamdan says while there is certainly a cosmetic benefit, this procedure is done to treat symptoms. Candidates for the procedure need to have something called greater saphenous vein reflux which is blood flowing in the wrong direction in the saphenous vein. Candidates should also have bulging veins and some pain in the legs.
"Since this is not considered a health worry across the country, a lot of patients don't even realize they're having symptoms," Dr. Hamdan says, "It's not just pain in the veins, it can be a buring, itching sensation or a heavy, tired sensation."
The procedure is done under local anesthesia and takes about an hour. The leg is wrapped in an ace bandage and patients can resume normal activity the next day. When medically necessary, it is covered by most insurance. Patients who have the characteristic symptoms should be evaluated by their doctor to discuss possible treatment options.
"The procedure itself was unbelievable," Tremblay says, "They gave me a sedative to relax me. It was seriously 45 minutes."
Tremblay says the pain in her leg is gone. She has also seen significant improvement with swelling and appearance that is only getting better with time.
"Because the bulges in my leg were so bad, I didn't think it would help the way they looked," Tremblay says, "But now that it has I think 'oh, I think I'll wear a skirt.'"
Whereas before Tremblay would end her work day having to keep her leg elevated, now she can get through the long shifts without having to sit down all the time.
"I can get through the day and not notice it at all." Tremblay said.
Above content provided Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted October 2008