Venous Program Offers Novel Glue Treatment to Seal Varicose Veins
In This Article
- Treatment of varicose veins has evolved over decades from painful stripping under general anesthesia to various forms of ablation
- The Fireman Vascular Center at Massachusetts General Hospital now offers a novel approach using medical adhesive to seal damaged veins
- Once a vein is sealed, the blood flow is rerouted to healthy veins, which improves symptoms
- Mass General is part of an ongoing prospective study establishing that the glue approach is just as effective as thermal ablation for sealing veins, but without pain or the need for compression stockings
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A novel alternative for varicose vein and spider vein treatment now available at the Fireman Vascular Center at Massachusetts General Hospital uses an adhesive to seal veins shut, redirecting the blood flow to healthier veins.
Previously, for patients with varicose and spider veins there was only one treatment choice: painful vein stripping under general anesthesia. That approach has evolved over decades to include radiofrequency and laser ablation, but now there are even newer alternatives, says Julianne Stoughton, MD, vascular surgeon and medical director of the Venous Disease Program at Mass General.
"Over the years, I have been a champion of various ablation methods, and treating a vein with heat is what we've been doing for 20 years," she says. "Glue is a novel approach that is gaining more and more popularity and application. It's becoming the future of venous treatment because it is really painless and immediate, and it doesn't require compression stockings."
Mass General is the only center in the northeast U.S. offering participation in this prospective post-market study for this novel adhesive approach.
Glue Quickly Treats Varicose and Spider Veins Painlessly
Varicose and spider veins can be a simple cosmetic nuisance for some patients, but they can also cause discomfort, itching, cramping and pain. They may even lead to more serious problems, such as venous ulcers, blood clots and bleeding.
The current standard of care often involves thermal ablation, which can cause swelling and bruising, and is not ideal if the treatment area is near other important anatomy (for example, nerves). Treatment before and after ablation often involves compression stockings, which can be cumbersome, particularly for larger patients.
The Vascular Center team's new approach uses a catheter to deliver a small amount of medical adhesive into a weak or damaged vein. Once that vein is sealed, blood is rerouted through healthier veins, which relieves symptoms.
"It's a simple, painless outpatient procedure. Basically, patients walk in and they walk out. They have almost no discomfort," Dr. Stoughton says. "It is a highly successful way of closing a vein without having to wear any compression stockings and without the risk of postoperative bleeding." As compared to traditional thermal ablation, the adhesive approach causes less bruising, and patients recover more quickly.
Dr. Stoughton participated in early studies of the adhesive in animal models, and now she has enrolled the Vascular Center in a multicenter post-market prospective trial comparing radiofrequency ablation and laser ablation to the novel glue approach to determine whether one method holds a significant advantage.
Dr. Stoughton has been using the adhesive very successfully on many patients with varicose veins. So far, the only adverse event is an allergic reaction to the glue. The venous team tests patients for hypersensitivity reactions before proceeding.
Continuing Innovation in Vascular Disease
Dr. Stoughton wants colleagues to understand how far varicose vein treatment has come and how many good options patients now have.
"We've always tried to find things that would rival thermal ablation. So we kept trying to find other ways to close the vein," Dr. Stoughton says. "We now have very automated processes that are technically easy to do and very successful in closing the vein. We have a lot of minimally invasive, painless, very safe and effective tools, depending on the patient's needs and preferences."
She believes that the adhesive's success in varicose veins will lead to its broader application in more complicated procedures, such as pelvic vein embolization and sclerotherapy, recanalization of veins after deep vein thrombosis, and the treatment of venous anomalies, arteriovenous malformations and venous ulcers.
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