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High-Speed Technology For Severe Varicose Veins | Article By Dr. Ronald Lev, Board Certified in Phlebology

Last updated 6 years ago

If you are interested in new and innovative varicose vein treatment options, below is an article written by Dr. Lev of Advanced Varicose Vein Treatments of Manhattan. This article was also distributed at last weeks Health Fair at the JCC Manhattan on Sunday. Please read through this information to learn more about the latest technology in treating varicose veins. If you have any further questions and/or want to schedule a consultation, please visit our website and call us at (212) 204-6501.

Varicose veins are an old problem – Hippocrates and the ancient Egyptians wrote about them – and for many seniors, they are an unfortunate rite of passage. Half of all Americans over 50, and two-thirds of women over 60, suffer from those big ropey leg veins. The problem is far more than cosmetic – the pain, swelling and leg fatigue can really discourage an active lifestyle, and severe varicose veins can even cause chronic infections and skin ulcerations. 

Varicose veins generally occur when the valves fail in the primary leg vein, which is called the greater saphenous. Those valves are supposed to push blood back up towards the heart, but when they can not do the job anymore, the blood pools up in the veins. Women with more than two children and people who work on their feet like nurses and teachers are particularly at risk, and heredity and obesity are also factors. It is a pretty common problem – I have seen patients younger than 20 and older than 90.

In the dark ages before the 21st Century, the only surgical treatment was stripping out the saphenous vein, a painful and barbaric procedure that required a general anesthetic and weeks of recovery. Needless to say, most patients avoided that operation if they could, and I still see lots of patients who have been suffering for decades and thought vein stripping was the only alternative. They are delighted to find out that medical technology has finally caught up with varicose veins, and we now have minimally-invasive office procedures that can deal with the problem in minutes. 

The breakthrough is catheter technology, the same kind that is used for heart interventions. Under a local anesthetic, we thread a catheter, about the thickness of a spaghetti noodle, into the vein to heat it from within and seal it off, rather than removing it. The doctor pulls the device through the vein, using either radiofrequency (RF) energy or laser to heat the vein walls and cause them to collapse inward on themselves. Once the vein is sealed, the body automatically re-routes blood flow through healthier vessels and normal circulation is restored. The varicosity symptoms quickly dissipate, and the sealed vein is eventually absorbed by the body. 

The speed and comfort of this technique are amazing to my patients. The device I use is called VNUS® ClosureFAST™, and it uses radiofrequency energy to seal a typical 45-centimeter length of vein (about 14 inches) in three to five minutes. The only discomfort the patient feels is a couple of needle sticks, and the procedure is so simple that I can perform it in my office under local anesthesia or a mild sedative and have the patient in and out in well under an hour. We encourage patients to get up and walk immediately after the procedure, and most return to normal activity the very next day. The pain and fatigue disappear almost instantly, and the swollen veins begin to deflate in a week or two. 

I prefer the RF device to the older laser catheters because the lasers operate at extremely high temperatures – over 800 degrees Fahrenheit – and that can be traumatic to the tissues, causing pain and bruising. RF operates at much lower temperatures – comparable to the Low setting on a crock pot – and it’s far more comfortable for the patient. Both devices are effective, but the latest studies of the ClosureFAST device give it the edge in my book. 

This procedure is considered a medical necessity, rather than cosmetic surgery, so it is covered by Medicare and most insurers. That clears away the one final barrier to longtime varicose vein sufferers seeking treatment, and as a result we are seeing lots of new patients these days. More men than ever before are requesting the procedure – having one’s varicose veins treated is no longer considered unmanly. And we have gotten a rush of interest in the tech

nology from active seniors in their 70s and 80s – their middle-aged children are undergoing the procedure, and when the parents see the results, they want the treatment themselves. I have had patients tell me they are wearing shorts for the first time in 40 years. 

There is so much media buzz about technology today that sometimes the simplest and most important breakthroughs get lost in the noise. For almost a hundred years, progress on treating varicose veins was, like the surgery itself, slow and painful. Now we have a fast and virtually painless way to change a patient’s life in a couple of minutes, and that’s a great feeling for a physician.  

Ronald Lev, MD., is certified by the American Board of Phlebology. He can be reached at (212)204-6501 or

Indication: The VNUS closure treatment is intended to treat blood vessels with superficial venous reflux, the underlying cause of varicose veins. 

Contraindications: Patients with thrombus in the vein segment to be treated.

Potential Risks and Complications: As with all medical procedures, there is the potential for complications including vessel perforation, thrombosis, pulmonary embolism, phlebitis, infection, hematoma ,arteriovenous fistula, nerve damage, and skin burn. Consult with a physician to receive more information.


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