Frequently Asked Questions
1. What is superficial venous reflux?
2. What is the Closure procedure?
3. How does it work to treat superficial venous reflux?
4. How is the Closure procedure different from vein stripping?
5. How long does the Closure procedure take?
6. Is the Closure procedure painful?
7. Will the procedure require any anesthesia?
8. How quickly after treatment can I return to normal activities?
9. How soon after treatment will my symptoms improve?
10. Is there any scarring, bruising, or swelling after the Closure procedure?
11. Are there any potential risks and complications associated with the Closure procedure?
12. Is the Closure procedure suitable for everyone?
13. Is age an important consideration for the Closure procedure?
14. How effective is the Closure procedure?
15. What happens to the treated vein left behind in the leg?
16. Is the Closure treatment covered by my insurance?
17. What are patients saying about the Closure procedure?
1.What is superficial venous reflux?
Superficial venous reflux is a condition that develops when the valves that usually keep blood flowing out of your legs become damaged or diseased. This causes blood to pool in your legs. Common symptoms include pain, swelling, leg heaviness and fatigue, as well as varicose veins in your legs.
2.What is the Closure procedure?
The Closure procedure is a minimally invasive treatment for superficial venous reflux. A thin catheter is inserted into the vein through a small opening. The catheter delivers radiofrequency (RF) energy to the vein wall, causing it to heat, collapse, and seal shut.
3.How does it work to treat superficial venous reflux?
Since valves can’t be repaired, the only alternative is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein. The Closure procedure provides a less invasive alternative to stripping by simply closing the problem vein instead. Once the diseased vein is closed, other healthy veins take over and empty blood from your legs.
4.How is the Closure procedure different from vein stripping?
During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein, after which a stripper tool is threaded through the saphenous vein and used to pull the vein out of your leg through a second incision just above your calf.
In the Closure procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special catheter inserted through a small puncture. This virtually eliminates the bruising and pain often associated with vein stripping (i.e., this may result from the tearing of side branch veins while the saphenous vein is pulled out). Vein stripping is usually performed in an operating room, under a general anesthetic, while the Closure procedure is performed on an outpatient basis, typically using local anesthesia.
Three randomized trials of the Closure procedure vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, the Closure procedure was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the Closure procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, Closure patients returned to work 7.7 days sooner than surgical patients. Patients treated with the Closure procedure had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.
5.How long does the Closure procedure take?
The Closure procedure takes approximately 45-60 minutes, though patients normally spend 90 minutes at The Richmond Vein Center due to normal pre- and post-treatment procedures.
6.Is the Closure procedure painful?
Patients report feeling little, if any, pain during the Closure procedure. Your physician will give you a local anesthetic to numb the treatment area.
7.Will the procedure require any anesthesia?
The Closure procedure can be performed under local or regional anesthesia.
8.How quickly after treatment can I return to normal activities?
Many patients can resume normal activities immediately. For a few weeks following the treatment, your doctor may recommend a regular walking regimen and suggest you refrain from very strenuous activvites (heavy lifting, for example) or prolonged periods of standing.
9.How soon after treatment will my symptoms improve?
Most patients report a noticeable improvement in their symptoms within 1 week following the procedure.
10.Is there any scarring, bruising, or swelling after the Closure procedure?
Patients report minimal to no scarring, bruising, or swelling following the Closure procedure.
11.Are there any potential risks and complications associated with the Closure procedure?
As with any medical intervention, potential risks and complications exist with the Closure procedure. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the Closure procedure at the consultation. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and/or skin burn.
12.Is the Closure procedure suitable for everyone?
Only a physician can tell you if the Closure procedure is a viable option for your vein problem. Experience has shown that the vast majority of patients with superficial venous reflux disease can be treated with the Closure procedure.
13.Is age an important consideration for the Closure procedure?
The most important step in determining whether or not the Closure procedure is appropriate for you is a complete ultrasound examination by your physician or qualified clinician. Age alone is not a factor in determining whether or not the Closure procedure is appropriate for you. The Closure procedure has been used to treat patients across a wide range of ages.
14.How effective is the Closure procedure?
Published data suggests that two years after treatment, 90% of the treated veins remain closed and free from reflux, the underlying cause of varicose veins.
15.What happens to the treated vein left behind in the leg?
The vein simply becomes fibrous tissue after treatment. Over time, the body will probably re-absorb this tissue. One study reported that the treated vein is indistinguishable from other body tissue one year after the Closure procedure was performed.
16.Is the Closure treatment covered by my insurance?
Most insurance companies are paying for the Closure procedure in full. Most insurance companies determine coverage for all treatments, including the Closure procedure, based on medical necessity. The VNUS Closure procedure has positive coverage policies with most major health insurers. Your physician can discuss your insurance coverage further at the time of consultation.
17.What are patients saying about the Closure procedure?
98% of patients who have undergone the Closure procedure are willing to recommend it to a friend or family member with similar leg vein problems.