The catheter is introduced into the main leaky varicose vein through a very small opening in the skin. The catheter is then passed up the vein to just below the level of the junction with the deep vein (sapheno-femoral junction or sapheno-popliteal) under ultrasound guidance.
The catheter will deliver the glue to the diseased varicose vein wall leading to complete closure of the varicose vein. After the diseased vein segment is closed the catheter is pulled back and the cycle repeated all the way down the thigh to the point of entry into the skin. Once the long truncal vein (long saphenous vein or short saphenous vein) is closed, blood flow is re-routed to other healthy veins in the limb. Following the procedure Immediate ambulation is encouraged and the patients return to normal activities within 24 hours.
Immediate ambulation is encouraged and the patients return to normal activities within 24 hours. The occluded varicose veins will then be obliterated and slowly removed by the body in the following months.
The main advantages of the VenaSeal technique are avoidance of multiple local anaesthetic injections and need for compression stockings after the procedure.
How good are the results of VenaSeal ablation?
The success of any Venaseal procedure is measured by:
- The occlusion rates (how many of the treated veins remain closed) after VenaSeal are in most series over 95% in the short term (about one month) and although this number reduces (some veins re-open) on follow up in good hands this is still between 85%- 95% after 1-2 years. It is unlikely for veins to recur (re-open) after this time.
- Reported complications following Venaseal technique occlusion of varicose veins include deep vein thrombosis (DVT), and superficial thrombophlebitis (pain, inflammation along the course of treated vein). The most serious of these, DVT, is generally less than 1% (although we have not seen a case in our practice).
Criticisms of minimally invasive procedures
One of the criticisms of endovenous ablation is that if phlebectomies (removal of the varicosed tributaries of side branches) are also required, a more extensive procedure needs to be planned possibly in an operating suite using general anaesthetic.
Arguably however, in many cases extensive multiple phlebectomies may not be required as many disappear once the pressure within the venous system is reduced by removing the source of reflux i.e.; the truncal vein (long or short saphenous vein). It is a point to bear in mind that the more extensive the varicosities are (specially if tortuous) the less likely that they will be suitable to endovenous methods.