Procedures

                

What is the Venefit procedure?

The Venefit 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.

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 from your leg. The Venefit procedure provides a less invasive alternative to vein 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.

How is the Venefit 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 Venefit procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special (Closure) catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping (i.e., that 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 Venefit procedure is performed on an outpatient basis, typically using local or regional anesthesia.

Three randomized trials of the Venefit procedure vs. vein stripping, including the most recent multi-center comparative trial, show very similar results. In the multi-center comparative trial, the Venefit procedure was superior to vein stripping in every statistically significant outcome. In the study, 80.5% of patients treated with the Venefit procedure returned to normal activities within one day, versus 46.9% of patients who underwent vein stripping. Also, Venefit patients returned to work 7.7 days sooner than surgical patients. Patients treated with the Venefit procedure had less postoperative pain, less bruising, faster recovery and fewer overall adverse events.1

How quickly after treatment can I return to normal activities?

Many patients can resume normal activities immediately.2 For a few weeks following the treatment, your doctor may recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.

Are there any potential risks and complications associated with the Venefit procedure?

As with any medical intervention, potential risks and complications exist with the Venefit procedure. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the Venefit procedure at the consultation, and can be reviewed in the safety summary. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and/or skin burn.

What is sclerotherapy?

A chemical injection, such as a saline or detergent solution, is injected into a vein, causing it to "spasm" or close up. Other veins then take over its work. This may bring only temporary success, and varicose veins frequently recur. It is most effective on smaller surface veins, less than 1-2mm in diameter.

What is ambulatory phlebectomy?

As with sclerotherapy, ambulatory phlebectomy is a surgical procedure for treating surface veins. Multiple small incisions are made along a varicose vein and it is "fished out" of the leg using surgical hooks or forceps. The procedure is done under local or regional anesthesia, in an operating room or an office procedure room.

 -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------

1 Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure) versus ligation and stripping in a selected patient population (EVOLVES study). J Vasc Surg 2003;38:207-14.

2 Goldman, H. Closure of the greater saphenous vein with endo radiofrequency thermal heating of the vein wall in combination with ambulatory phlebectomy: preliminary 6-month follow-up. Dermatol Surg 2000; 26:452-456.

3 Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg 2002;35:1190-6.

4 Weiss RA, et al. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up, Dermatologic Surgery, Jan 2002; 28:1: 38-42

5 Whiteley, MS, Holstock JM, Price BA, Scott MJ, Gallagher TM. Radiofrequency ablation of refluxing great saphenous systems, giacomini veins, and incompetent perforating veins using VNUS Closure and TRLOP technique. Abstract from Journal of Endovascular Therapy 2003; 10:I-46.

6 Pichot O, Sessa C, Chandler JG, Nuta M, Perrin M. Role of duplex imaging in endovenous obliteration for primary venous insufficiency. J. Endovasc Ther 2000;7:451-9.