What is vein stripping?

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Traditionally, superficial venous reflux at the saphenofemoral junction (in the groin) was treated surgically by ligation (tying) and division of the saphenous vein trunk and all proximal tributaries followed by stripping of the great saphenous vein (vein stripping). This combined procedure was referred to as "ligation and stripping".

 

image of 'vein stripping' taken from healthatoz.com on January 21, 2009

Proximal ligation requires a small (sometimes large) incision at the groin crease. Stripping of the vein may require additional incisions in the thigh, at the knee or below the knee and ankle. Historically, it is associated with a high incidence of morbidity. Today, patients stay in the hospital for at least 8 hours and get discharged with bandages from ankle to groin. Typical return to work is one to 4 weeks. When the operation was conceived some 40 years ago, patients stayed in the hospital for days and some died from pulmonary embolism because they were immobile and limited to bed rest. Although modern surgical techniques have made ligation and stripping procedures less invasive, it is still an operation that causes significant discomfort and precludes patients from returning to their daily routine.

Ablation of the vein by VNUS Closure is a newer procedure that is less invasive than surgery and has a much lower complication rate. Newer in the sense that it has replaced "vein stripping" and has been FDA approved since 1999 and over 1 million people have had this procedure in the United States. Perhaps 1.5 million patients have had the VNUS Closure procedure worldwide!

The procedure is well tolerated by patients and produces good cosmetic results. Good clinical results are observed at 7 years follow-up according to a recent multinational prospective study.

VNUS FAST Closure is a variation of the 1st generator catheter and is used almost exclusively now in the United States. Instead of a pronged tip, it uses a 7 cm coil to deliver radiofrequency energy to a 7 cm segment of vein. The great saphenous vein can be ablated with the VNUS Closure FAST catheter to treat saphenofemoral venous reflux disease. Similarly, the lesser (or short) saphenous vein can be ablated with the VNUS Closure FAST catheter to treat sapenopopliteal venous reflux disease with good success.

Although other surgeons were quick to adopt this second generation FAST catheter, Dr. Karamanoukian waited for the clinical results to be published in the scientific literature before adopting it and using it in his patients. Having published over 140 scientific articles, Dr. Karamanoukian believes that adopting new technology should await hard proven scientific data. However, Dr. karamanoukian is the first surgeon in the world to perform bilateral VNUS Closure procedures at the same office setting! This is very helpful in reducing the number of trips to the Vein Treatment Center and allowing the patient to resume all activities as soon as possible, typically returning to work the same afternoon and certainly by next morning! 

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Buffalo General Surgeon