Vnus closure procedure pros and cons, Recovery, Complications

You can suffer from superficial venous reflux disease if you feel pain, inflammation and have varicose veins in your legs. In the U.S, 26 million adults struggle from this disease. Individuals presenting with venous reflux will typically require surgery for vein stripping. Closure technique is now possible to treat patients – a micro-surgical replacement to intense venous removal operation.

When the valves that generally keep blood circulating out of your legs become weakened or deformed, venous reflux or venous insufficiency usually happens.

Re-routing blood supply to stable veins is the primary standard management. This has been done historically by eliminating (stripping) the problematic vein from the leg surgically. By removing the diseased vein directly, closure offers a minimally invasive surgery as compared to vein stripping.

Either using localized or generalized anesthesia in which the doctor desensitizes the leg before surgery, the closure procedure may be done as an outpatient procedure. It is presently performed in a clinical setting, although it can also be performed in the workplace of a doctor. The procedure is comprised of 4 main phases:

Map the Vein of the Saphenous. To locate its position, a standard procedure starts with non - invasive ultrasound scans of the deformed vein. This helps the surgeon to assess the place of insertion of the closure catheter and to identify the desired catheter tip position to initiate treatment.

Insert the catheter of the closure. The Closure catheter is introduced into the vein after the practitioner locates the saphenous vein and progresses to the uppermost section of the vein. An amount of dilute anaesthetic fluid is then usually administered into the region surrounding the vein by the surgeon. This desensitises the leg, allows for draining blood from the vein and creates a layer of fluid outside the vein to cover the surrounding tissue from heating until the catheter begins to supply RF energy. Saline is then gradually injected from the tip of the catheter into the vein to help create a near-bloodless field within the vein, enabling the catheter, rather than the blood, to heat the vein wall selectively.

Deliver RF energy and catheter removal. To validate the catheter tip position, diagnostic ultrasound is used, and the surgeon then stimulates the RF generator, allowing the electrodes at the end of the catheter to heat the vein wall to a target temperature of usually 85 ° C. or 185 degrees ° f. The vein shrinks when the vein wall is heated, and the catheter is removed progressively. The RF generator periodically changes the energy output to sustain the set-point during catheter pullback, which usually occurs over 20 to 30 minutes, to successfully compress collagen in the vein wall and close the vein over an extensive period.

Confirm Vein Closing. Ultrasonography is used throughout treatment to ensure the closure of the vein. The catheter can be re-positioned and energy re-applied if a part of the vein isn't really closed. After the operation is completed, the narrowed vein will eventually become fibrous over time, essentially blocking the flow of blood and directing it to the healthier veins instead. Typically, skilled surgeons complete the operation in 30 to 60 minutes.

99 % of patients who underwent the closure procedure are happy to suggest it to an acquaintance or member of their family.

In general, surgeons advise their patients to exercise regularly for a few days after the closure operation and come back for an ultrasonic evaluation within seven days. Over several days or even weeks after the operation, surgeons may recommend compression socks to be worn. As a standard item for vein procedures, compression stockings are recommended with the aim of improving patient satisfaction in the early days after surgery.

Usually, patients undergoing the closure procedure regain daily activities in a day or two. 

Pros and cons:

• Pain relief
• Method for outpatients (minimally invasive)
• Generally, restore activity in less than a day,
• With minimum to no skin damage, bleeding, or inflammation, good cosmetic outcome
• With the Closure method, as with any surgical procedure, potential risk and complications might occur.