The closurefast catheter attached to the VNUS radiofrequency generator.
Ultrasound imaging uses high frequency sound waves to produce pictures of the inside of the body. In vein treatment, it is used to map out the veins and to detect venous reflux or blockages to blood flow (such as blood clots). The machine is also used as an aid in the placement of a needle, a catheter, or a laser fiber during foam Sclerotherapy or endovenous ablation, such as Venefit™ or EVLT procedures.
Varicose Vein Radiofrequency Treatment (Venefit™ or VNUS™ Closure Procedure)
Venefit™ - Best Endovenous Thermal Ablation Procedure Performed by Dr. R. Dishakjian, M.D., Phlebologist
Venefit™ Targeted Endovenous Therapy (previously called VNUS closure procedure) is a clinically proven, minimally invasive, non-surgical procedure that treats varicose veins on an outpatient basis, with minimal discomfort. The Venefit™ procedure is described as endovenous, because a varicose vein is thermally ablated from within the vein. Thermal ablation of a vein with Venefit™ is achieved by means a catheter equipped with radiofrequency (RF) generating electrode. It is for this reason that the procedure is also known as Endovenous Radiofrequency Ablation (RFA).
Nu Vela Vein Center has been one of the first Vein Centers in the San Fernando Valley region of Southern California to introduce the Venefit™ Targeted Endovenous. Currently, the system is one of the two FDA-approved endovenous modalities for the comprehensive treatment of varicose veins; the other being Endovenous Varicose Veins Laser Treatment (EVLT).
VNUS CLOSURE™ OF THE SAPHENOUS VEIN
The Veins that are Targeted by Venefit
Nowadays, vein surgeons use endovenous thermal ablation, Venefit™ or EVLT, when leg vein Ultrasound mapping indicates the presence of incompetent saphenous and perforator veins. Incompetence in the veins usually results from the improper functioning of vein valves, allowing blood to pool in the very superficial leg veins. The condition is known as venous reflux.
Once the problematic saphenous/perforator veins are closed under the influence of the heat delivered by the electrode of the Venefit™ system, the blood-flow in the deep veins reverts to its normal pattern towards the heart. As a consequence, branch varicosities; that is, large and very superficial veins that are most obvious to the patient, adjust back to normal pressure conditions and dramatic visible improvement in the appearance of the legs is observed within a few weeks. Some of the residual veins may need additional treatments, such as microphlebectomy (ambulatory phlebectomy), foam sclerotherapy (for branch varicosities), or sclerotherapy (for reticular and spider veins). The closure of incompetent saphenous and perforator veins is of crucial importance in varicose vein treatment for preventing the recurrence of the condition.
At present, the RFA catheters supplied by Venefit come in two sizes: a large catheter, 7 cm long (Covidien ClosureFast™ Catheter) intended for the ablation of the Greater saphenous vein, and a small catheter, ClosureRFS™ stylet, 3 cm long, which can be used for the ablation of the smaller saphenous vein, tributary veins and perforator veins.
The Venefit™ Procedure
During a varicose vein treatment session, your physician uses duplex ultrasound guidance to locate the trouble causing vein and then accurately positions the Venefit™ Radiofrequency (RF) catheter tip into the diseased vein through a small tube he/she has inserted into the vein through a tiny incision. The vein doctor then injects a large amount of numbing solution around the vein that has to be treated. A second role of the numbing solution, besides its numbing action, is to serve like an insulating sleeve and protect the surrounding tissues from heat damage. As the RF energy is delivered and the catheter is withdrawn, the heat applied to the vein wall destroys its regenerative capacity and shrinks its collagen, leading to its permanent closure. The treated leg is then wrapped, and compression stockings applied in the doctor's office. Although patients are able to walk immediately, and usually return to normal activity the next day, they are advised to arrange for transportation back home as the treated leg may be partially numb.
In the weeks that follow the procedure, Dr. Dishakjian, the phlebologist (vein doctor) of the center, will monitor the progress of your recovery, and accordingly recommend an appropriate procedure to eliminate any residual veins to achieve the best cosmetic outcome with the least discomfort.
Insuance Coverage of Venefit™
Among minimally invasive varicose veins treatment procedures, the Venefit™procedure has one of the broadest and most complete insurance coverage available. Eligibility of reimbursement is based on established medical necessity as defined by the presence of symptomatic venous reflux non-responsive to conservative treatment methods. Moreover, at our vein center, three quarters of what you pay for the diagnostic Ultrasound test is reimbursed as payment towards varicose vein treatment.
VENEFIT™ (VNUS) PROCEDURE AT NU VELA ESTHETICA
Answers to Frequently Asked Questions about Venefit™ Targeted Therapy
Instructions for preparing yourself for Venefit™ Targeted Endovenous Therapy of varicose veins and aftercare are essentially the same as those recommended for Endovenous Laser Treatment (EVLT). Please click Click EVLT & Venefit FAQ for answers to questions you may have about these procedures, or go to varicose veins- FAQ to find answers related to varicose veins and their treatment.
The VNUS ClosureRFS™ Stylet for Endovenous Ablation of Perforator Veins
Recent studies have indicated that there is a clear correlation between having incompetent perforator veins (short communicating veins between the superficial and deep vein systems along the leg) and the recurrence of varicose veins. Accordingly, when incompetent perforator veins are present, ablation of the large superficial saphenous veins with the VNUS ClosureFAST™ catheter alone may only partially correct venous insufficiency, requiring the treatment of the incompetent perforating veins for optimal outcome.
To this end, VNUS™ Medical Technologies has extended the Closure procedure, and introduced the VNUS ClosureRFS™ stylet. The ClosureRFS™ stylet with its smaller catheter is intended to treat several other smaller veins, including anatomically suitable refluxing perforator veins.
Currently, the VNUS ClosureRFS™ stylet (re-named Venefit ClosureRFS™ stylet) is the only endovenous ablation device specifically cleared by FDA for the treatment of incompetent refluxing perforating veins. These veins are the most common origin of venous stasis ulcers that occur despite the successful closure of saphenous veins. These ulcers commonly occur along the inner aspect of the leg around the ankle and poorly respond to conventional treatments with antibiotics, wound care, and compression therapy.
Dr. Dishakjian, the phlebologist at the Vein Clinic, will use Duplex Ultrasound imaging to detect the presence of any refluxing perforator veins and accordingly suggest a treatment plan. Perforator vein treatment with the ClosureRFS™ stylet is an outpatient procedure, which can be either the primary treatment, or it can be performed in addition to the saphenous vein ablation with the Venefit™ catheter.