What is another option for the VNUS closure?
I was scheduled yesterday morning to have the VNUS closure done on my left leg. My doctor worked for an hour and then stopped and said he was unsuccessful due to the vein being too small and he couldn’t get the catheter in it. He said that we would need to discuss other options at another time.
Answers from doctors (6)
Was treatment not successful because the vein constricted during the attempt at catheterization or because it is just a small vein? If the former, then treatment can be attempted at another time - weeks later. If the vein is just too small, then the question is why is it being treated. If the vein is small, is it causing any signs or symptoms of venous insufficiency? You need to discuss this matter with your physician, who should be able to provide you with the answers to your questions.
Published on Jul 11, 2012
There are several other options to VNUS closure including laser ablation, VenaSeal Glue, Varithena Foam and Clarivein (mechanicochemical ablation). All options have pros and cons, so discuss this with your treating physician.
Published on Jul 11, 2012
Well, in my experience that's very rare. There are cases where the vein may be too small to access in the calf, but it is usually of adequate size in the distal thigh to successfully thread the sheath and VNUS catheter (actually called the ClosureFAST since 2007). There are other closure catheters available, specifically LASER and Venaseal which I use in my practice in addition to ClosureFAST. I think the next step for you is to research other Vein Specialists in your area and perhaps seek a second opinion, request another vein ultrasound to make sure the problem vein has not thrombosed as a result of the attempted closure procedure. If it has, then you are done. If it is still open and leaking, and your signs or symptoms are significant, then the size of the vein (mm in diameter) would determine which method of closure to perform. I prefer LASER with the smaller veins as the sheath size is 2 sizes smaller than that required for the ClosureFAST. Some providers who treat veins "part time" may not perform both modalities so do your research on training, level and depth of experience and which modalities are offered. Your vein may have been in spasm, you may not have been hydrated enough
Published on Jul 11, 2012
The Laser is equivalent to VNUS. The laser is smaller and will pass through a small vessel. Varithena is a foam that is passed through a tiny needle. There is also a glue used for the same purpose. You have plenty of options.
Published on Jul 11, 2012
Endovenous laser or VenaSeal are great options.
Published on Jul 11, 2012
VenaSeal is another option. Come and see the experts.
Published on Jul 11, 2012
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