Fifth in a series of articles by Mark Whiteley of The Whiteley Clinic, about Varicose Veins and the treatments available for them. Here he explains the new VNUS Closure method for treating varicose veins.

The “old” operation of tying the veins in the groin and stripping the main vein away causes several problems. The cut in the groin is often painful and can get infected. Stripping the vein leaves a painful bruise in the thigh and our research shows about 1 in 4 people start to grow the vein back within one year.

In 1998 a company called VNUS invented a new instrument to avoid these problems. They invented a catheter – a long thin tube the width of a biro refill but about a metre long – that can be passed along the inside of the vein. Using ultrasound, the catheter can be inserted into the vein to be treated through a tiny 3 mm cut. Once inside the vein the ultrasound is used to position it precisely.

When it is in the right place, the end is opened and electrodes contact the vein wall. These heat the vein wall to 85 degrees centigrade, which closes the vein completely. The tissue in the wall is damaged but does not burst – so there is no bruising. Over the next 6 months the vein is completely reabsorbed leaving no chance of it growing back again.

In March 1999 we performed the first VNUS Closure in the UK using this technique under General Anesthetic. We have continuously modified and improved our technique and we have the largest series of VNUS Closure procedures in the world. Currently we are checking our patients who had VNUS Closure 5 years ago and have not yet found a single vein that has re-opened.

We have now started to do VNUS Closure under local anaesthesia in selected patients. There will be an article examining this later in this series.