A leg up

A leg up

Procedure gives varicose vein patients new option

July 29th, 2010 by Clint Cooper in Health

Dr. Griffin Coates said when his patients walk out of his office he and his wife often get hugs.

"I never got that with heart surgery," he said.

Dr. Coates and his wife, Andi, a registered nurse, operate Vein Therapies of Chattanooga, a practice dedicated to the treatment of varicose veins in the legs through the new VNUS Closure Procedure.

The FDA-approved procedure, he said, allows for minimally invasive, outpatient treatment of patients through a tiny catheter and radio-frequency energy. An estimated 35 million to 40 million Americans have varicose veins.

Staff Photo by Allison Kwesell Dr. Griffin Coates inserts a VNUS Closure catheter into a varicose vein through a small opening in the skin. The catheter is powered by radio-frequency energy, which delivers heat to the vein and eventually seals it closed.

Staff Photo by Allison Kwesell Dr. Griffin Coates inserts...

The procedure is an alternative to the long-standard vein stripping surgery. It is similar to another minimally invasive procedure in which laser energy is delivered within a catheter.

According to the VNUS Medical Technologies website, Dr. Coates is the only doctor in Chattanooga using the procedure. The next closest practice, according to the website, is Surgical Associates in Cleveland, Tenn.

The difference in the two minimally invasive surgeries is evident in a 2007 single-blind trial of the two procedures, Dr. Coates said.

In the trial of 69 patients (and 87 legs), the patents who received the radio-frequency treatment had less pain, less tenderness, less bruising, less recovery time and fewer adverse events than patients who received endovenous laser therapy.

While the trial was sponsored by VNUS Medical Technologies, it was independently reviewed for completeness and accuracy, according to the study.

"It is kinder and gentler to patients," Mrs. Coates said. "The catheter (using radio frequency) does not get as hot (as using the laser). It's really rather remarkable. People walk out saying, 'I can't believe it was so easy.'"

Dr. Coates said his search for varicose vein therapy for himself led him to the VNUS procedure, which was developed in 1999, and to a new specialty.

"I had done vein stripping (as a surgeon)," he said, "and I knew I never wanted to have that."

After researching and exploring options, Dr. Coates focused on the VNUS Closure Procedure. After watching several of the procedures, he said he liked the setup, the technology and the doctor, and elected to have it himself four years ago.

"Within three days, I felt like I had taken off five pounds of ankle weights," he said.

Since the former thoracic and cardiac surgeon opened his practice on Shallowford Road some two and a half years ago, he has performed between 500 and 600 of the procedures.

Robert Byrd, 62, of Chickamauga, Ga., had the procedure on both legs, one at a time. He said he had suffered particularly from poor circulation in his feet.

"I feel great," he said. "I've had no pain at all."

While the practice has other therapies for treating spider veins, Mr. Byrd said even his spider veins have dissipated.

Mary Mosteller, 67, of Chatsworth, Ga., said she had varicose veins, a lot of pain and often woke up in the night with leg cramps. She recently had one leg treated and soon will have the other done.

Now, she said, her veins "don't protrude out. The overall look is really good. I've been really pleased."

In the procedure itself, when the energy is delivered and the catheter withdrawn, the vein wall is heated. That, in turn, causes the collagen in the wall to shrink and the vein to close. Once the diseased vein is closed, blood is rerouted to other healthy veins.

Generally, Dr. Coates said, the entire procedure is completed in less than an hour. Often, Dr. Coates said, they return to work after the procedure.

Because they are not anesthetized, there are no side effects from being put to sleep and very little, if any, pain, he said.

The Coates said Medicare and 98 percent of insurance policies cover the procedure if it is considered medically necessary.