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Frequently Asked Questions : The Closure Procedure

What is the Closure Procedure?

The Closure procedure is a minimally invasive treatment for superficial venous reflux. A thin catheter is inserted into the vein through a small opening. The catheter delivers radiofrequency (RF) energy to the vein wall, causing it to heat, collapse, and seal shut.

How does it work to treat superficial venous reflux?

Since valves can't be repaired, the only alternative is to re-route blood flow through healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. The Closure procedure provides a less invasive alternative to vein stripping by simply closing the problem vein instead. Once the diseased vein is closed, other healthy veins take over and empty blood from your legs.

How is the Closure procedure different from vein stripping?

During a stripping procedure, the surgeon makes an incision in your groin and ties off the vein, after which a stripper tool is threaded through the saphenous vein and used to pull the vein out of your leg through a second incision just above your calf.

In the Closure procedure, there is no need for groin surgery. Instead, the vein remains in place and is closed using a special (Closure) catheter inserted through a small puncture. This may eliminate the bruising and pain often associated with vein stripping (i.e., that may result from the tearing of side branch veins while the saphenous vein is pulled out). Vein stripping is usually performed in an operating room, under a general anesthetic, while the Closure procedure is performed on an outpatient basis, typically using local or regional anesthesia.

How long does the Closure procedure take?

The Closure procedure takes approximately 15-20 minutes, though patients normally spend 2 hours at the medical facility due to normal pre- and post-treatment procedures.

Is the Closure procedure painful?

Patients report feeling little, if any, pain during the Closure procedure. Dr. Neimat will give you a local anesthetic to numb the treatment area. How quickly after treatment can I return to normal activities?

Many patients can resume normal activities immediately. For a few weeks following the treatment, your doctor may recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.







How soon after treatment will my symptoms improve?

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

Is there any scarring, bruising, or swelling after the Closure procedure?

Patients report minimal to no scarring, bruising, or swelling following the Closure procedure.

Are there any potential risks associated with the Closure procedure?

As with any medical intervention, potential risks and complications exist with the Closure procedure. All patients will consult with Dr. Neimat to determine if their conditions present any special risks. Dr. Neimat will review potential complications of the Closure procedure at their consultation.

How effective is the Closure procedure?

Published data suggests that two years after treatment, 90% of the treated veins remain closed and free from reflux, the underlying cause of varicose veins.

What happens to the treated vein left behind in the leg?

The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue. One study reported that 89% of treated veins are indistinguishable from other body tissue one year after the Closure procedure was performed.

Is the Closure treatment covered by my insurance?

Many insurance companies are paying for the Closure procedure in part or in full. Most insurance companies determine coverage for all treatments, including the Closure procedure, based on medical necessity. The VNUS Closure procedure has positive coverage policies with most major health insurers.