Answers

Replied on 4/13/2013

By: Center for Vein Care and Surgery  |  Robert A. Edwards, D.O., Horizons Diagnostics, LLC
Opelika, AL

In my practice, the Venefit (formerly known as VNUS) closure procedure is performed in the office, in a relaxed setting, and without the need for general anesthesia. A patient may be offered a mild oral anti-anxiety agent one hour prior to the procedure. However, many patients do not want to take any medications and do very well with the procedure being performed with local anesthesia. They often walk in and out within an hour and are driven home by someone. They may drive and resume normal activities and exercises the next day.

Replied on 6/6/2012

By: Dr. Michael Gioscia, MD, FACS, FACPh  |  
White Plains, NY

I have been performing the VNUS Closure procedure since 2001, and, for the past seven years have done the procedure exclusively in the office using local anesthesia (tumesent). There is absolutely no need for general anesthesia, intravenous sedation, or spinal. As a matter of comfort, I prescribe a low dose of Valium (2.5- 5.0 mg).

Replied on 3/6/2012

By: Vein Centers of Texas  |  Charles J. Rodman, MD
Charles Moore, M.D.
Corpus Christi, TX

General anesthesia is not normally recommended in an out patient setting when having radiofrequency VNUS ablation done.

Replied on 3/5/2012

By: Vein Centers of Texas  |  Charles J. Rodman, MD
Charles J. Gutierrez, M.D.
Beaumont, TX

No. It should be done under local tumescent anesthesia. General anesthesia is much more dangerous than the actual procedure. One important factor is if you feel pain or heat, the Surgeon must know as to prevent permanent nerve damage. There is no need for general.

Replied on 2/2/2012

By: Advanced Vein Center  |  Bruce R. Hoyle, M.D.
Orange, CA

It is totally unnecessary to do this procedure under general anesthetic. I
have done thousands of these procedures in an office setting using local
(tumescent) anesthetic without complications.

Replied on 2/2/2012

By: Lafayette Regional Vein Center  |  Dr. Marlin W. Schul, MD, MBA, RVT, FACPh
Lafayette, IN

This is a very important question and one you should take seriously.

I perform VNUS and endovenous laser for saphenous veins and would note recommend general anesthesia. In the reports of side effects/complications from VNUS under general anesthesia, the rate of deep vein thrombosis is much higher. This is likely due to limited mobility immediately following the procedure as you recover from the anesthesia.

There are many ways to treat varicose and spider veins, but the reality is that treatment is rarely performed at a hospital and general anesthesia is relatively contraindicated for thermal ablation alone. I would discuss this with your doctor and ask why the need for general anesthesia and what his/her experience has been with local tumescent anesthesia placed with ultrasound guidance. In my practice, tumescent anesthesia is all that is necessary to keep a patient pain free during the procedure.

In closing, I cannot possibly over emphasize the importance of walking following the procedure. General anesthesia will slow your recovery and ability to walk, raising your risk of deep vein thrombosis. I hope you have received this reply in time to consider the comments above.
Best wishes

Replied on 2/1/2012

By: Vein Specialists at Royal Palm Square  |  Joseph G. Magnant, M.D., F.A.C.S.
Fort Myers, FL

I have not used general anesthesia to perform VNUS or laser closure since I
first started in 2002. I have performed more the 7000 cases in the past 6
years and have never, I repeat NEVER, have not been able to successfully
perform the procedure under local anesthesia with only a small amount of
oral sedation (ativan 1-2 mg). Having the patient awake is safer, and also
allows the patient to tell me if they feel any "burning" in which case I can
stop immediately and place more liquid around the vein.

Replied on 2/1/2012

By: Vanish Vein and Laser Center  |  Dr. John Landi, FACS, RPVI, RPhS
Medical Director, Diplomate Am. Board of Phlebology
Naples, FL

Local anesthesia is the anesthesia of choice. Actually the anesthesia is called tumescent anesthesia.

Replied on 2/1/2012

By: VeinCare Centers of Tennessee  |  Stephen F. Daugherty, M.D.,F.A.C.S.
Clarksville, TN

I would avoid general anesthesia for a radiofrequency or LASER ablation procedure. There is no need for the risk, cost, or inconvenience of general anesthesia.

Stephen F. Daugherty, MD, FACS, RVT, RPhS

More Questions on VNUS

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I wore the compression sock on the treated leg for the first two weeks. I stopped wearing it for the next three weeks but the healing process seems to be taking longer than I'd like. Is there any issue with me wearing the compression sock again? Will it promote healing?

How soon can I resume squatting to pick things up after the VNUS procedure? (8 answers)
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Do I need VNUS if I have only mild GSV reflux? (8 answers)
I'm a 25-year-old female who developed spider veins on thighs and blue reticular veins behind knee both legs 3 years ago. I had ultrasound and found out I have 0.3 to 0.5 sec reflux in GSV right leg. My doctor told me I have to do VNUS, but I don't have symptoms, so is the VNUS a good idea?

I now have 10 times the amount of blue veins down my outer legs after VNUS. Is this common and what is happening? (8 answers)
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Are there long-term side effects or considerations in removing the saphenous vein? (8 answers)
I am 34 years old and want to proceed with VNUS and phlebectomy as a treatment for saphenous vein reflux. I have unsightly red, blue, and brown spots and enlarged veins on my feet. Are there any long-term effects of saphenous vein removal to consider?

Is VNUS the same as EVLT? (8 answers)
They sound kind of the same. Can they both treat varicose veins?

Is PAD different from venous reflux? (7 answers)
If a patient has PAD, is that different from venous reflux?

How long does it take for reduction of visible calf veins after VNUS? (7 answers)
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Spider vein (7 answers)
Hi, I have big problem with spider veins on my whole body, especially my breasts and beside my legs. My question is the treatment used for legs can be applied to breats and other parts of the body safely?

Should I be concerned about bruising on hip and buttocks? (7 answers)
I had one vein in my left thigh treated three days ago, and I'm due for a second in two days. I just noticed a few small, very dark bruises on my left hip and buttock. Any relationship to closure? Should I be concerned about clots? I have no pain or other symptoms.

Should I have a second VNUS closure if I am still experiencing major pain in the leg that was first treated? (7 answers)
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Can treated veins reappear after going away? (7 answers)
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Why is my husband still having excruciating pain 1 month after two VNUS closure procedures? (7 answers)
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What would cause discoloration after a VNUS closure? (6 answers)
I had the VNUS procedure performed almost a week ago on one leg. Already I have a reddish-brown discoloration spreading on the front/inside of my calf. It's different from the bruising that is near my incision. What is this?

Is it normal to have swelling 5 weeks after the VNUS closure procedure? (6 answers)
I had the VNUS closure procedure done on both legs about 5 weeks ago and followed up with sclerotherapy approximately 3 weeks ago. Now I am having severe swelling in my left ankle, like it was before the procedure ever happened. My ankles were fine up til now. Is this normal?

Can vomiting reopen a closed vein? (6 answers)
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Can drinking alcohol affect the VNUS closure procedure? (6 answers)
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Can abdominal exercises reopen a closed vein after ten days? (6 answers)
I had the VNUS closure procedure on the greater saphenous vein of my left leg. After a week, an ultrasound confirmed the vein was closed. My doctor said that I could resume all activities and exercises. Is this true? Are sit ups and leg lifts okay?

Is it normal for compression stockings to cause pain after the VNUS closure procedure? (6 answers)
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Is VNUS with removal of the saphenous vein and phlebectomy safe in someone with Raynauds? (6 answers)
I have Raynaud's phenomenon, which has been deemed unlikely to be associated with other conditions. I am going to have my saphenous vein removed followed by phlebectomy to treat venous insufficiency. Is this safe in relation to Raynaud's?

Next Step When VNUS Has Failed? (6 answers)
I had VNUS on the greater saphenous veins in both legs 3 months ago. Ultrasound shows that both veins closed. However, I've had no pain reduction. One leg looks identical to how it looked before the procedure & the other looks worse! What can I do?

Will not having the procudeure repeated result in potential problems? (6 answers)
After three years an ultrasound revealed that the vein is leaking and will need to be redone. What exactly does leaking mean and what problems could arise if I elect not to have the procudure repeated?

Is normal the leg been swollow??? (6 answers)
I did the vein cloure 3 days ago, I don't feel pain, but my leg is very swollen, this is normal? Also, I'm scheduled to do the other leg in a month, can I skip this???

What would cause large ulcers on one leg after the VNUS treatment? (6 answers)
What would cause large ulcers on one leg after the VNUS treatment? One leg developed seven ulcers the size of quarters but the second leg had no ulcers, except for small blisters.

Is it safe to have VNUS surgery if I have PAD and claudication of both legs? (6 answers)
Is this safe?

How long do I need to be off work after a venous ablation? (6 answers)
Does the procedure have down time?

How does VNUS treat superficial venous reflux? (5 answers)
What does the procedure involve?

Why did my VNUS cause multiple ulcers on my lower leg & ankle bone? (5 answers)
Within 5 minutes of VNUS surgery I had 7 large ulcers from the knee down. Any explanation why this would occur in only 1 leg? Could nerve damage in the leg from Shingles be a factor?

Is there a certain weight of a patient a doctor would not on do needle VNUS closure on? (5 answers)


What is the reason for the redness in my foot from ankle to inner arch? (5 answers)
I had RFA done three months agobilateral with entry point of catheter at ankle for dilated GSV and SSV in both legs. I still have swelling in calf areas after sitting for 15-20 minutes and redness from ankle right through the inner arch of both feet. Is that normal?

VNUS closure didn't work? (5 answers)
I had VNUS done a year ago. It doesn't seem like there is any difference in the appearance of my veins. They still bulge when I stand. My doctor says this is caused by new veins which developed after the surgery. Do I need to have it done again?

Is it normal to have a cross between a bruising feeling and a numb feeling in your inner thigh 3 months post VNUS closure? (5 answers)
I had VNUS closure on 09/07/12 for my right leg and I am still experiencing an (aching) bruising and numb feeling in my inner thigh. I noticed an actual bruise yesterday. Is this normal? My follow-up is not until April and wondering if I should be seen sooner?

Can VNUS be performed if someone has very tiny veins? (5 answers)
My doctor tried but it was so painful trying to get the needle in the vein that he actually stopped trying. I am now turning to sclerotherapy for my veins.

Will support stockings eliminate venous ulcers? (5 answers)
I had a VNUS procedure done and got an ulceration on the ankle. Is this normal? Will support stockings help, or do I need to do something else?

Can anxiety affect the success of the VNUS closure procedure? (5 answers)
I had the VNUS closure procedure done on the greater saphenous vein of my left leg and I suffer from occasional anxiety attacks and hot flashes. Can hot flashes and an increased heart rate affect the ability of the treated vein to remain closed?

After the VNUS closure, is it normal to have a numb/tingling sensenation following exercise? (4 answers)
I waited three weeks before exercising, although I did walk following the VNUS procedure. The day after I exercised, I started experiencing mild pain, numbness and tingling in my lower leg and foot. It is worse after sitting and feels better after walking. Is this normal? What should I do?

PAD vs. ARTERIAL (4 answers)
What is the difference between PAD & Arterial disease? If you have arterial disease & PAD should you wear compression stockings?

I had VNUS on my right leg yesterday and everything was fine until last night I started having sharp stabbing pain around the foot and ankle. (4 answers)
The pain started on the top of my foot but has now moved to my Achilles tendon area. The pain stops when I stand up for a while but when I lay down with my leg on a pillow like I was told to do the pain returns. What could be causing the pain?

What does VNUS stand for? (4 answers)
How is it different from EVLT and ELVeS?

How long does it take to for the pain/heaviness to go away after vnus closure? (4 answers)
I had the procedure done a little over three weeks ago and am still having pain/heaviness. It was started at the ankle and up to my groin. Does that mean the vein has not fully closed?

How does VNUS compare to EVLT? (4 answers)
Which is the best procedure?

My surgeon said the numbness was normal. Will it go away? (4 answers)
I had the closure procedure done October 2010. I am suffering with the left leg. I have tingling/numbness by the inner ankle, and sharp pains when I run. My Surgeon said this was normal. Can I expect this pain to go away? I am only 24.

Is early VNUS treatment better? (4 answers)
Recently my greater saphenous veins have become noticeably enlarged at my ankles. Exercise now causes previously invisible calf veins to show. Does early treatment result in significantly better outcome? Can veins become enlarged but not varicose?

I continue to have pain after VNUS surgery. (4 answers)
I had VNUS surgery 3 years ago on my left leg. I have a dull ache in my leg that I never had before surgery. I especially notice it at night in bed. It often bothers me enough to wake me up. I never had the ache before surgery. What causes this?

Pain at night while sleeping after 10 days of having VNUS (4 answers)
I had vnus procedure 10 days ago; veins are gone and bruising is quickly going away. I've severe pain & burning sensation while sleeping; similar to the start of a Charlie horse and build up of lactic acid x10! Only in 1 leg; the worse of the 2.

Swelling above knee after VNUS and schlerotherapy. (4 answers)
I had the VNUS procedure done 3 years ago. I've had schlerotherapy each subsequent year. This year I noticed a swelling above the knee following treatment. This was 9 months ago and still hasn't gone away. What could this be?

One year after VNUS treatment, injections? (3 answers)
My earlier question was regarding the ankle numbness I am still experiencing when I touch it. I went to a new provider, and they want to do sclerotherapy on the cluster of spider veins on my ankle where it's numb. Will it get worse or better?

I have large amounts of pain in my leg that I didn't have before after havign VNUS done. (3 answers)
The pain is intense with numbness and tingling. Will this go away or is this nerve damage?

Who wouldn't be a good candidate for VNUS/ELVT procedures? (3 answers)
Who would not be a good candidate for VNUS/ELVT procedures?

What is the difference between VNUS and EVLT? (3 answers)
Both procedures sound like they treat the greater saphenous vein. So what’s the difference between them?

VNUS in Calf & Thigh? (3 answers)
My doctor told me that I am one of the rare (5%) of patients needing VNUS treatment in the saphenous veins in both my thighs and calves, due to the insufficiencies shown in the duplex ultrasound. Can you tell me more? Is this more serious than usual?

Still numb to light touches after a year. (3 answers)
It has been a year since my VNUS closure and I'm still numb to light touches on my ankle. I feel like it has gotten better, but is it safe to say I'm stuck like this forever? or could something be pushing on the nerve stopping the healing?

Swollen ankles (3 answers)
I had venous and foam treatment to both of my legs one week ago. Recovery is good although my thigh is very bruised and tender. However, my ankles appear swollen. Is this normal?

Nausea after procedure normal after VNUS closure procedure? (3 answers)
I just had the VNUS closure procedure this AM. Is it normal to feel nauseated and just a little light headed since the procedure?

Extreme aching in my calf and achilles tendon since having sclerotherapy (2 answers)
I had VNUS done in April in my groin and in my calf. My leg healed I began to have aching and pain in the injection sights (groin and calf). I also have mysterious aching in my achilles tendon as well. I had an ulstrasound and my veins were fine.

Had VNUS done and the same day I forgot and lifted a 15-20lb box. My left leg was still numb so there was no pain. How do I know if I damaged it? (2 answers)
I have had no meds for 6 hours and woke up a bit stiff but no escurciating pain. I just want to know if I damaged it somehow by lifting? Thanks!

Venous Insufficiency - Thighs & Calves (2 answers)
My doctor told me that I am one of the rare (5%) of patients needing VNUS treatment in the saphenous veins in both my thighs and calves, due to the insufficiencies shown in the duplex ultrasound. Can you tell me more? Is this more serious than usual?

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