Buffalo General Surgeons

What is the VNUS Closure Procedure?

My doctor recommended the VNUS closure procedure for my leg. Please tell me more about it.

I have several posts about VNUS Closure for you to read.

In essence, VNUS FAST Closure treats venous reflux disease where leaky valves in the veins cause reflux of blood backwards into the legs, whether it originates in the groin into the greater saphenous vien or behind the leg into the short saphenous veins.

Instead of the old ligation and stripping procedure, the vein is obliterated endoluminally, meaning from inside using radiofrequency energy with VNUS Closure or laser energy with EVLT.

Either procedure is highly successful in trained hands and you should do a thorough investigation and find out how many procedures the doctor has done before you sign up.

Hratch Karamanoukian, MD

Buffalo General Surgeon

Treatment for Bulging Vein on my Ankle Bone?

I have a bulging vein on my ankle bone. What is the best vein reatment to get rid of it?

The specific vein you are talking about just above the inside ankle bone is the great saphenous vein which may be quite prominent in some individuals and normal in most. Take a look at the ankles of most young people, they all have this vein just over the medial (inside) ankle bone. Yours may be very prominent.

Endovenous procedures are not performed for this particular problem unless venous reflux extends all the way down here from the groin, called saphenofemoral venous reflux disease. If it involes the outside of the ankle, that is the short saphenous system in which ablation can be helpful. In most cases, if I understand your description, this requires a 20 minute office microphlebectomy procedure. Consult a phlebologist (vein specialist) or vascular surgeon who has an interest in phlebology.

Hratch Karamanoukian, MD

Buffalo General Surgeon

Does Sclarotherapy Work?

I'm 30 years old and plan to get sclarotherapy. do it work and what are the side effects? How much does it cost?

Sclerotherapy is effective when appropriate veins are chosen for injection, always from proximal to distal areas of the lower extremities.

You asked about side effects and most importantly one should remember that any of the sclerosant solutions can cause hyperpigmentation which in rare cases, can last as long as a year or more.

To prevent hyperpigmentation, meticulous technique should be used as well as avoiding excessive pressure during the injection process to avoid extravasation of blood. As well, treating venous reflux disease will also reduce the likelihood of hyperpigmentation.

Another important problem can be clot formation in injected reticular veins which should be evacuated with a micro puncture blade to minimize dermal pigmentation - i.e. hyperpigmentation.

Sclerotherapy should be avoided in patients that have a history of deep vein thrombosis, in patients who are pregnant and patients who have phlebitis. It is also important to make sure that the patient is observed for 30 minutes in the office as some individuals can have hypersensitivity reactions that could be deadly (very rare).

Hratch Karamanoukian, MD

Buffalo General Surgeon