Frequently Asked Questions - The ClosureŽ Procedure
What is superficial venous reflux?
Superficial venous reflux is a condition that develops when the valves that usually keep blood flowing out of your legs become damaged or diseased. This causes blood to pool in your legs. Common symptoms of superficial venous reflux include pain, swelling, leg heaviness and fatigue, as well as varicose veins in your legs.
What is the ClosureŽ procedure?
The ClosureŽ 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 thermal 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 ClosureŽ 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 ClosureŽ 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 ClosureŽ 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 ClosureŽ procedure is performed on an outpatient basis, typically using local or regional anesthesia.
Is the ClosureŽ procedure painful?
Although some people are more sensitive than others, patients generally report little pain. Some have said they can feel a little heat when the catheter is energized.
Will the procedure require any anesthesia?
The ClosureŽ procedure can be performed under local, regional, or general anesthesia.
How quickly after treatment can I return to normal activities?
Many patients typically return to normal activities within a day.1 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.
(Note: These results were obtained using VNUS ClosureŽ and VNUS ClosurePlus; RF products with expandable extrodes)
How soon after treatment will my symptoms improve?
Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.
Is there any scarring, bruising, or swelling after the ClosureŽ procedure?
Patients report minimal to no scarring, bruising, or swelling following the ClosureŽ procedure.
Are there any potential risks and complications associated with the ClosureŽ procedure?
As with any medical intervention, potential risks and complications exist with the Closure procedure. All patients should consult their doctors to determine if their conditions present any special risks. Your physician will review potential complications of the ClosureŽ procedure at the consultation, and can be reviewed in the safety summary. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, adjacent nerve injury (tingling or numbness) and/or skin burn.
Is the ClosureŽ procedure suitable for everyone?
Only a physician call tell you if the ClosureŽ procedure is a viable option for your vein problem. Experience has shown that many patients with superficial venous reflux disease can be treated with the ClosureŽ procedure.
Is age an important consideration for the ClosureŽ procedure?
The most important step in determining whether or not the ClosureŽ procedure is appropriate for you is a complete ultrasound examination by your physician or qualified clinician. Age alone is not a factor in determining whether or not the ClosureŽ procedure is appropriate for you. The ClosureŽ procedure has been used to treat patients across a wide range of ages.
What happens to the treated vein left behind in the leg?
The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue.
Is the ClosureŽ treatment covered by my insurance?
Many insurance companies are paying for the ClosureŽ procedure in part or in full. Most insurance companies determine coverage for all treatments, including the ClosureŽ procedure, based on medical necessity. The VNUS® ClosureŽ procedure has positive coverage policies with most major health insurers. Your physician can discuss your insurance coverage further at the time of consultation.
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.