By Dr. Jonathan Calure, President & Surgical Director of Maryland Vein Professionals
For decades, vein stripping was the recommended procedure for treating varicose veins. Today, minimally invasive procedures such as Endovenous Radiofrequency Ablation (RFA) have become the preferred treatment modality. This article briefly describes both procedures.
Radiofrequency ablation is a minimally-invasive procedure that uses radiofrequency (RF) energy to provide an even, uniform heat to contract collagen in the vein walls. This causes them to to collapse and seal, redirecting blood flow to healthy veins.
This procedure is performed as an outpatient treatment using local anesthesia. In comparison to older techniques like vein stripping, this procedure results in less pain, minimal or no scarring, and minor bruising. Patients can return to work the same day, as well as resuming other normal activities and light exercise. The procedure is covered by most insurance plans, including Medicare.
In a large international, multi-center study published in December 2012, 99% of participants were free of pathological venous reflux after one year. After five years, 95% were reflux-free.
Once a common technique that was popular in the 1980s and 1990s, vein
stripping typically required the removal of the great saphenous vein (GSV). Performed in the hospital under general anesthesia, the surgeon would pass a stripping cable through the GSV from an incision in the patient’s ankle to the groin, where it was secured to the open end of the vein.
Next, the surgeon would pull the cable out through the ankle incision, bringing the vein with it. In some cases, surface veins would also be removed, requiring multiple incisions and scarring. Operating times for vein stripping could be one to two hours. Many patients reported a 1-2 week recovery time with post-operative pain, limited activity, and missed days from work.
Dr. Calure was one of the first surgeons on the East Coast to have a practice exclusively dedicated to minimally-invasive vein care. He has performed 23,000 successful RFA treatments and his practice has been recognized as a Center of Excellence for Minimally Invasive Vein Care.