Minimally invasive treatment of varicose veins: VNUS CLOSURE FAST - SEGMENTAL ENDOVENOUS ABLATION WITH RADIOFREQUENCY WAVES Technique

A new and much easier method to treat varicose veins is attractive for more and more patients; the intervention requires little time, you are admitted to the clinic as an outpatient and after a few hours you can go home on your own. You must have your compression stockings on you. This method can be recommended to you only after a Doppler ultrasound consultation, depending on the severity of the case.

After the classic surgical methods have long been the reference cure (vein stripping or removal), the field is increasingly taken over by minimally invasive methods and endovenous approach, respectively, with the closure and maintenance of the incompetent superficial veins.

These endovenous techniques, initiated in the 90s, tend to become the „rule of thumb” worldwide in phlebology and their application in private clinics, within the so-called "one day surgery", seems to be the future of this field.

This technique performed within Academica Medical Centre is an advanced therapy through which plastic surgery can be successfully avoided. The procedures consist of introducing a catheter through the vein, usually in the popliteal region (behind the knee) which will gradually release energy in the affected area. Academica Medical Centre also performs the diagnosis of the varicose disease by means of the most advanced ultrasound technique - DOPPLER DUPLEX, actually one of the most correct methods used to identify the presence of the venous reflux (an abnormal return of the blood inside the veins) which goes unnoticed many times during the clinical examination.

The method consists of closing (occlusion) of the great saphenous vein (when it is incompetent) at the thigh level by means of radiofrequency waves. Consequently, the venous reflex is abated on this level, together with the disappearance of the overstressing of the venous reflux.

When needed, VNUS CLOSURE also allows the approach of other insufficient venous branches (perforated veins), thus performing not only the esthetic treatment, but the removal of the cause of deficient venous reflux, too. Radiofrequency provides a controlled thermal energy which increases the temperature of the vascular wall. It is a technique similar to the laser surgery, but it uses heat as a method to destroy the varicose vein. The catheter is placed on the varicose vein, under the ultrasound device (under doppler control) and it is able to perform the segmental occlusion of 7 cm of the vein in 20 seconds. The procedure is performed under local anesthesia and it takes approximately 30 – 45 minutes.

The advantages of this method are unique:

• it is a minimally invasive method, so with a minimal discomfort for the patient;
• the one-of-a-kind esthetic results;
• it is performed in an outpatient system;
• almost with no post-procedure pain at all;
• elegant, it does not leave hematomas or inflammations;
• the patient can immediately (the second day) return to his/her activity;
• fast (lasting 30 - 45 minutes);
• made under local anesthesia;
• it is a method kindly recommended to friends and family members by 98% of the patients who performed it as patients;
• doctors are thrilled by its immediate and long-term efficacy, by its simplicity and rapidity and by the satisfaction of the patients;
• CLOSURE FAST technique does not only remove by occlusion the varicose vein, but it also has an effect on the disease itself abating the venous reflux;
• the benefic effect is maintained on a long-term.

VNUS Closure Fast method consists of the following steps:

1. Identification by means of doppler ultrasound of the cause of the disease (reflux areas with incompetent valves) and performance of the venous layout mapping (the map);
2. Insertion of the catheter inside the great saphenous vein by a simple venous puncture (usually in the posterior area of the knee);
3. Positioning of the head of the catheter (active segment) throughout the vein and towards the base of the thigh under the confluence area of the superficial and deep veins – under Doppler visualization;
4. Energy release in "bundles": 7 cm of the vein are closed in 20 seconds then the active segment is withdrawn 7 cm and another energy bundle is released;
5. The repetition of the energy release for each new segment of 7 cm, for 20 seconds, obtaining the occlusion of the great saphenous vein;
6. Doppler control of the vein’s layout after the intervention in order to highlight the occlusion and the reflux absence;
7. The application of an elastic bandage which is to be kept permanently for 72 hours (3 days) when the patient returns for a Doppler check-up;
8. Walking after 30 minutes from the procedure and return to the usual daily activity even from the second day, maintaining a second class contention elastic stocking for 2 weeks and indication to walk every day;
9. Pain relief medication when needed and anti-clotting medication according to the indication of the doctor.

At Academica Medical Centre the technique is performed by Dr. Toni Feodor, at Academica Aviatorilor.