New Less-Invasive Treatments for Varicose Veins

Regan and patient small

Barbara Greenberg wasn't happy with the bulging varicose veins on the side and back of her legs.

She wasn't happy with the "achiness'' and "heavy legs'' she endured for years.  

And she wasn't happy when newcomers would show up at canoe outings in the mountains of Ashe County where she lives because it meant they would see her in shorts.

But it took until she fainted because of severe cramps in her thighs that she finally took action.

Her Internet search for solutions to her varicose veins led her to Wake Forest Baptist Health and John Regan, MD. Over the course of a few months last year, Regan performed laser ablation surgery on the great saphenous vein and a phlebectomy in her left leg (the worse one) and gave her right leg a clinical trial injectable medicine. She went home the same day from both procedures.

"Where I was having these cramps in my thigh that laid me out on the floor, since then I have not had one,'' Greenberg says.

As for her ugly bulging veins, "they're gone,'' she says. "One hundred percent gone.''

Minimally invasive  

"With the increased use of ultrasound, we can now better diagnose problems, tailor treatment more specifically to the abnormality in the patient and just generally be more creative in what we do to minimize the procedure and really target what is bothering them,'' Regan says.

"We commonly see people who deal with these problems for years and years and then finally get to the point where they say 'I can't take this any more and I'm going to do something about it,'" he says. Whether the problems with veins are painful or simply cosmetic in nature, "things can be done to improve their lifestyle and improve their self-image as well.''

Regan has worked at Wake Forest Baptist for 19 years after serving a fellowship at a hospital in Virginia and become a leader in his field, watching the previous standard treatment of "vein stripping''-surgery in which a wire is inserted into the body with incisions and the vein pulled out-fall by the wayside. 

"With minimally invasive procedures, patients are up walking immediately. There's virtually no down time. Potential complications are eliminated,'' he says. "And actually, long-term outcomes seem to be better with less-invasive procedures.''

 'Make them feel better' 

Regan says it was late in medical school when he became interested in minimally invasive techniques for managing vascular disease.

"I thought there was an opportunity here to develop a clinically oriented practice in interventional radiology.

"We're primarily dealing with people who have correctible medical problems,'' he says. "We can make them look better. We can make them feel better.''

Chris Koontz, 48, an application system engineer for Wells Fargo, had been running for close to eight years and noticed over time a dull ache in his legs at night, in addition to the bulging veins on the inside of his calves.

"It was so slow in developing,'' he says. "You're not cognizant that that's what causing your problem. You just live with it. And slowly, over time, it becomes part of your routine, your sensation.''

Like Greenberg, he did his own research on the Internet and wound up calling Regan, who earlier this year did laser ablation surgeries on Koontz's legs.

Koontz was quickly back on his feet doing his prescribed walking exercises. Today, back to running, he says, he feels 20 years younger.

"It's been night and day, the freedom.''

For Greenberg, the surgery on her left leg was problem-free. She had to walk several times a day and keep the leg elevated for a couple of weeks. With the injection in her right leg, she noticed a gradual improvement and end to the thigh cramps as her varicose vein faded away.

She says she is pleased to have been able to have both her legs repaired using the combination of surgery and clinical trial medication. An added benefit for the trial was that she got $300 for being part of the study of Varisolve, the microfoam treatment that was injected to eliminate the problem vein in her right leg.

The medicine is made by BTG International, a London-based pharmaceutical company; Regan has worked with the trial medicine for several years, from early trial stages.

Greenberg says that with a clinical trial, "there's always the fear of 'what if something goes wrong?'

"But it felt comfortable that I was in good hands and Dr. Regan was the one teaching this procedure and doing this study at other hospitals around the country."

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Last Updated: 10-11-2013
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