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For release, Tuesday, March 28

NON-SURGICAL PROCEDURE 95 PERCENT EFFECTIVE IN TREATING VARICOSE VEINS

SAN DIEGO -- Painful, unattractive varicose veins in the legs can be eliminated with a revolutionary new non-surgical procedure that shrinks the veins with heat, according to research from a multicenter study being presented here today at the 25th Annual Scientific Meeting of the Society of Cardiovascular & Interventional Radiology (SCVIR).

The interventional radiology technique, which involves using radiofrequency (RF) energy to heat the problem vein from the inside, has been 95 percent effective in shrinking varicose veins. The vein-shrinking procedure is a minimally invasive alternative to the two standard treatments for varicose veins of the legs: the surgical removal or tying off of leg veins; and clotting the main vein, which has a high rate of recurrence.

"This will revolutionize vein treatment in the United States," said Mark Marzano, M.D., one of the study researchers and an interventional radiologist with Vein Care Associates, Barrington, Ill. "It's a relatively simple procedure and has many advantages over surgery, which can be painful, involves several incisions and requires the use of general anesthesia, which can lead to complications."

About 15 percent of U.S. adults and as many as half of people 50 and older suffer from varicose veins. Three-quarters of sufferers are women. The often-painful problem usually is caused by the backflow of blood in the saphenous vein, the large vein that runs the length of the inner leg. The valves in the saphenous vein normally push the blood flow upward toward the heart, but can weaken and allow blood to flow backward or pool. Branch vessels of the saphenous vein, which are closest to the surface of the skin, then become varicose, or tortuous and dilated. Eczema, ulcers and pigmentation changes of the skin can develop as a result. Pregnant and overweight women, and those with a family history of varicose veins, are at highest risk to develop the condition.

In the study, conducted at 33 centers worldwide, 371 legs in 336 patients were successfully treated with the procedure. After six months, 209 of 221 legs (95 percent) remained free of reflux, or backflow. Phlebectomy, or removal of branch veins through a tiny incision, was performed in addition to the vein-shrinking procedure in 139 legs (37 percent).

In the procedure, the patient is given a local anesthetic, and a tiny nick (less than 1/4 inch) is made in the vein behind the knee. A small catheter, or tube, is inserted and guided to the top of the saphenous vein at the groin using ultrasound to monitor the progress of the procedure. A probe is carried to the site in the catheter and tiny electrodes are deployed into the vein to deliver radiofrequency energy and heat the inner wall of the vein. This causes the collagen in the vein wall to contract and the vein to shrink and close off. Nearby veins take over circulation of blood in the legs.

"Typically, patients go back to work the next day," said Dr. Marzano. "I've had patients go dancing, mountain climbing, jogging or play tennis the next day."

The vein-shrinking procedure is offered at 25 centers throughout the United States and the number is growing.

Standard treatment for varicose veins typically involves surgical ligation, (tying off of veins) and/or removal ("stripping") of all or part of the saphenous vein and some of its branches. Surgery is often done under general anesthesia, and bruising and scarring are common side effects. Recovery can take two weeks or more. Another treatment, called sclerotherapy, involves injecting an irritant into the vein to clot it off; however, the blood flow in the veins often recurs and only about half of patients report improvement in their symptoms.

Co-author of a paper on the topic being presented at SCVIR by Dr. Marzano is S. Yunez, M.D.

An estimated 5,000 people are attending the Annual Scientific Meeting in San Diego, Calif., of SCVIR, a professional society based in Fairfax, Va., for physicians who specialize in minimally invasive interventional procedures.

An interventional radiologist is a physician who has special training to diagnose and treat illness using miniature tools and imaging guidance. Typically, the interventional radiologist performs procedures through a very small nick in the skin, about the size of a pencil tip. Interventional radiology treatments are generally easier for the patient than surgery because they involve no surgical incisions, less pain and shorter hospital stays.

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Editor's note: Study numbers are current as of March 15, and may change.