Curious how foam sclerotherapy works? Watch an animation here. For more vein procedure videos, go to La Jolla Vein Care’s Youtube channel.
Vein Stripping is a thing of the past! Watch La Jolla Vein Care’s Dr. Bunke on San Diego Living explain alternative non-surgical vein treatments to the outdated vein stripping surgery! The episode was aired yesterday, February 10th, on CW’s Channel 6. As Dr. Bunke explains, a common misperception about varicose vein treatment is that vein stripping surgery is still used as the main method used to treat varicose veins. The truth is, vein stripping surgery is nearly obsolete, with endovenous ablation being considered as the standard of care for treatment of the great saphenous and small saphenous veins. There are other treatment methods such as ultrasound guided foam sclerotherapy for the branching, bulging veins at the surface of the skin.
This news segment provides animations about how these vein treatments work.
For the endovenous ablation, specifically radiofrequency ablation of varicose veins, also known as the Venefit procedure (previously called VNUS Closure) is described. Dr. Bunke explains that a thin, flexible tubing called a catheter is placed inside the diseased vein. Radiofrequency energy is delivered to h
eat the vein and seal it shut. The body will gradually dissolve the treated vein. The blood is directed through other healthy veins.
A foam sclerotherapy animation is also shown. Foam sclerotherapy involves injecting a foamed medicine into the vein that will cause it to collapse, shrink and eventually dissolve.
These varicose vein procedures are minimally invasive and can be performed in the office without general anesthesia and almost immediate return to normal activities.
In 1994 and 1950, E.J. Orbach introduced the concept of a macro bubble air-block technique to enhance the properties of sclerosant in performing macrosclerotherapy. Apparently, few vascular surgeons were interested in the subject and the technique languished. The work of Juan Cabrera and colleagues in Spain attracted attention of some vein specialists and interest in the use of foam technology in treating venous insufficiency was reawakened. Administration of foamed sclerosant was reintroduced in the early 1990s by Cabrerra, who summarized a broad experience in 1997. By the 1990’s, broad use of diagnostic ultrasound imaging made it possible to monitor foam distribution with ultrasound scanning. Some 40 years earlier, and before the development of ultrasound scanning, foam had been used in Germany to treat varicose veins. At that time, foam was made by special syringes and its distribution was assessed by touch, instead of ultrasound scanning. Tessari , prior to the year 2000 developed an easy way of making liquid sclerosant into foam using two syringes and a three-way stop cock. By 2000, Sica was able to report a three-year experience using foamed sclerosant in treating saphenous varices. Since that time, foam has appeared increasingly in general use. Around 2000, Dr. John Bergan began describing the utility and success of foam treatment to physicians in the United States and can be attributed to bringing its awareness to North America. Over the past decade foam has gained world-wide popularity for the treatment of varicose vein tributaries in place of surgery. Varithena foam was recently FDA approved to treat the great saphenous vein with foam sclerotherapy. Dr. Bergan predicted that microfoam sclerotherapy will eventually replace all other methods. Presently, it is most commonly used as an adjunct to endovenous ablation of the great and small saphenous veins or as a sole treatment for surface varicose veins.
We’re often asked, ‘Am I too old to treat my varicose veins?’ The answer is no. Since modern varicose vein treatments are largely non-surgical, there are appropriate treatment options for those of any age. While varicose veins are more common with each decade of life, they can appear on young teenagers or at any time in older adults. For active older adults, addressing varicose vein conditions is even more important to maintain healthy legs. Otherwise, symptoms of leg heaviness, fatigue, swelling and pain can slow you down. There are other complications of untreated varicose veins such as superficial thrombophlebitis, varicose vein rupture and leg ulceration, in severe cases. There are a variety of minimally invasive treatment options for varicose veins, and depending on the individual preference, severity of the condition and the veins affected will help you and your doctor determine the best treatment course.
In November of 2013, the US Food and Drug Administration (FDA) approved Varithena,™ a new type of foam treatment for the treatment of patients with incompetent veins and visible varicosities of the great saphenous vein (GSV) system. Varithena™ is a pharmaceutical-grade, low-nitrogen, polidocanol foam dispensed from a canister device. In two pivotal, placebo-controlled Phase III trials, VANISH-1 and VANISH-2, Varithena™ achieved a clinically meaningful improvement in the symptoms of superficial venous incompetence and the appearance of visible varicosities and addressed the underlying venous incompetence in the majority of patients treated. Varithena™ (polidocanol injectable foam) is a sclerosing agent indicated for the treatment of incompetent great saphenous veins, accessory saphenous veins and visible varicosities of the great saphenous vein system above and below the knee. Varithena™ improves the symptoms of superficial venous incompetence and the appearance of visible varicosities. Treatment is a minimally invasive, non-surgical procedure that requires neither tumescent anesthesia nor sedation. Foam sclerotherapy has been used for years by medical doctors. What is new with Varithena™ , is that the foam is pre-made with low-nitrogen as opposed to room air, and is dispensed in a proprietary canister. It is not yet available in doctors offices. Making Foam
The June 1st episode of The Dr. Oz Show brought attention to foam sclerotherapy. He describes it as latest, most advanced technique to eradicate painful, varicose veins. Dr. Oz’s guest demonstrated how the procedure is performed: He used a vein light to visualize the veins, followed by a painless injection of a foamed solution. He also mentions that the old Varicose Vein Treatments hurt because of the saline solution that used to be used, but newer solutions such as polidocanol, are nearly painless.
We’re pleased that Dr. Oz brought much need attention to foam sclerotherapy, as we have been using it as an alternative to surgery for years. What most people don’t realize is that foam sclerotherapy is not new, but rather newly recognized. Foam sclerotherapy offers patients a non-surgical alternative for the treatment of varicose veins. There is essentially no down-time and return to normal activities is immediate.
La Jolla Vein Care
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