The VNUS® procedure is a minimally invasive treatment alternative for patients with a condition known as superficial venous reflux, often resulting in varicose veins and other painful symptoms. Varicose veins are known for their distinctive blue color and bulging appearance on the skin. They resemble large, elongated striations, and they afflict an estimated 10%-20% of the adult population, the majority of which are women.

The procedure is an outpatient procedure performed in doctors' offices, surgical centers and hospitals. Local anesthesia with moderate sedation is used to ensure comfort during treatment. Using a single needle stick or a small incision, a thin catheter is inserted into the greater saphenous vein. The catheter delivers radiofrequency (RF) energy to the vein wall, causing it to heat, collapse and seal shut.

Once the diseased vein is closed, other healthy veins take over and empty blood from your legs. As normal return flow is re-established, your symptoms should improve noticeably.

Following the procedure, the catheter is removed, a bandage is placed over the insertion site and your leg may be wrapped typically for 1 day to aid healing. Your doctor may ask you to walk, wear compression stockings, and to refrain from standing for long periods of time following the procedure to help speed your recovery. Many patients resume normal activity within 1-2 days.

Patient benefits of the VNUS Closure include minimally invasiveness, requiring no general anesthesia and the ability for most patients to walk out of the medical facility within hours. Stripping is often performed under general anesthesia which necessitates a longer time within the medical facility. Convalescence following stripping can take weeks and involve significant pain.

What is the VNUS Closure procedure?
The VNUS Closure procedure is an alternative treatment option to the older more traditional vein stripping surgery. The Closure procedure is a new minimally invasive treatment for superficial varicose veins. The procedure involves placement of a thin catheter into the vein through a small opening in the skin and radiofrequency waves are applied to the vein. This energy released from the radiofrequency catheter causes the vein to heat and collapse, eventually causing disappearance of the vein.

How does the closure procedure work?

When the valves in the vein become incompetent or defective, blood starts to pool in the leg instead of going forward to the heart. With time, the varicose veins increase in size and get engorged with blood. With the Closure procedure, the defective vein is treated with energy and there is no need for surgery. Once the diseased vein is treated, no more blood returns back to the leg and the varicosity disappears.

How is it done?

The Closure procedure is performed on an outpatient basis. The entire procedure is done under ultrasound visualization. The leg is cleaned and a local anesthetic injected in to the thigh area just above the knee. Then a small needle is placed into the vein and through it is guided a Closure Cather. When the catheter is in position, Radiofrequency energy is applied to the vein and the catheter is withdrawn. The radiofrequency energy heats up the vein and causes it to collapse. This leads to eventual closure of the vein.

Following the procedure, a bandage is placed over the insertion site, and additional compression is provided to keep the area clean. One is encouraged to walk and resume all normal activities.

How is the Closure procedure different from vein stripping?

The Closure procedure does not require general anesthesia and is a less extensive procedure than vein stripping. The recovery period is also much shorter than surgery. Patients treated with the Closure procedure have less postoperative pain, less bruising, faster recovery and fewer overall complications.

How long does the Closure procedure take?
The Closure procedure takes approximately 30-60 minutes. After the procedure, patients are observed and able to go home the same day.

Is the Closure procedure painful?

Some patients report mild pain during the Closure procedure. For those who feel any pain, a local anesthetic can be given to numb the skin.

How quickly after treatment can I return to normal activities?
The majority of individuals resume their normal activities in a day. Continued walking and a resumption of normal activities is highly encouraged. For those into sports and heavy lifting, a delay of 5-7 days should be appropriate.

How soon after treatment will my symptoms improve?

Most patients report marked improvement in their symptoms within 1-2 weeks following the procedure. The cosmetic appearance usually takes a few more months.

What are side effects of the Closure procedure?

Patients report minimal to no scarring, bruising, or swelling following the Closure procedure. Most of these disappear in 1-2 weeks.

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. Potential complications include:

  1. vessel perforation
  2. thrombosis
  3. pulmonary embolism
  4. phlebitis
  5. hematoma
  6. infection
  7. paresthesia (numbness or tingling)
  8. skin burn

Is the Closure procedure suitable for everyone?
The Closure procedure is only for large varicose veins. It is not suitable for spider veins. Veins which do not have leaky valves and which are normal should not be removed, because future open heart surgery may require the use of these veins. The Closure procedure has been used to treat patients across a wide range of ages

How effective is the Closure procedure?
Current data indicates that two years after treatment, the majority of treated veins remain closed and free from reflux. When the Closure procedure fails it is usually the fault of the device or the lack of experience of the physician.

What happens to the treated vein left behind in the leg?
The treated vein collapses and becomes fibrous tissue. Over time, the vein disappears.

Is the Closure treatment covered by my insurance?

If the patient with varicose vein has symptoms, many insurance companies cover the cost of the Closure procedure in part or in full. However, most insurance companies want a trial of stockings and exercise before surgery is undertaken.

Disclaimer: This information is intended only as an introduction to this procedure. This information should not be used to determine whether you will have the procedure performed nor does it guarantee results of your elective surgery. Further details regarding surgical standards and procedures should be discussed with your physician.

By Staff
Updated: October 14, 2009

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The Prairie Vein Clinic is one of the specialized areas of services offered by Prairie Vascular Services. Prairie Vascular is the segment of Prairie Cardiovascular devoted to the care of patients with complicated vascular diseases. Prairie Vascular provides cutting edge, evidenced based care for patients through dedication to research, education, and future technologies.  Prairie’s physicians have trained at top medical institutions and come from around the world to practice, research and teach at Prairie Cardiovascular.  Whether a patient’s condition entails medical therapy or revascularization, our physicians will provide the patient and family members with a comprehensive assessment and treatment plan focused on restoring the patient’s quality of life.

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