About :: News - Sayonara Varicose Veins

Michael Kassouf, M.D., attending surgeon, performs saphenous vein occlusion procedure.

sayonara varicose veins - published by the Dept. of Public Affairs - February 18, 2002, #732

Nancy arrived at New York Methodist Hospital to receive treatment for painful varicose veins and a swollen leg. When she walked out of the Hospital later that day, the large vein, which was causing the problem – the saphenous vein – had been effectively “turned off” during a minimally invasive procedure. What’s more she had no pain. “I didn’t even have to take an aspirin!” she said.

Nancy's procedure, called saphenous vein occlusion or closure, received FDA approval in 1999. If she had been treated earlier, she would have had the vein removed – a much more extensive procedure – which would have resulted in a longer recovery period. Instead, Nancy was on her feet in no time.

A single saphenous vein runs form the top to the bottom of each leg. Its job is to help return oxygen-depleted blood to the heart. When the valves, which are designed to prevent blood from flowing backwards, don’t function properly (a condition called superficial venous reflux) numerous problems occur, including swelling, pain, fatigue, and varicose veins.

Varicose veins, which affect 10 to 20 percent of all adults but serve no useful purpose in the body, are swollen, twisted, blue veins near the skin’s surface. Because the valves are damaged, they hold more blood at a higher pressure than normal. This forces fluid into the surrounding tissue, making the affected leg swell and feel heavy. When the saphenous vein fails to function properly, varicose veins develop.

Whether the condition is caused by genetics, pregnancy, excess weight, or inadequate exercise, the physiology of varicose veins is the same. The valves don’t function properly, and the vein is stretched and distorted from the increased pressure caused by blood flowing in the wrong direction. The condition is painful, unattractive, and occasionally even life threatening. “The swelling and pain can prevent an individual from wearing shoes and from walking. It may also result in the development of ulcers on the feet. In the worst case scenario, a blood clot, caused by the damaged vein, may become lethal if it travels to the lungs,” said David Glass, M.D. attending surgeon.

First lines of defense may include wearing support hose, eating less, and exercising more. However, when these lifestyle changes are ineffective, surgery may be necessary.

“We use a venous Doppler (a sonogram to test vein function) to determine whether or not the saphenous vein is functioning properly. If it is not, we collapse the vein. If you have a vein problem, don’t wait to see your physician,” said Dr. Glass. When the condition has advanced, open surgery may be necessary.

“Many varicose veins shrink and some disappear altogether, in the months following the procedure,” said Dr. Kassouf. the function of the failed saphenous vein is taken over by other veins,” explained Michael Kassouf, M.D. attending surgeon.