Is glue (VenaSeal) the best way to shut down the saphenous vein?
- Posted on: May 19 2016
For the past fifteen years, lasers and radiofrequency catheters have competed to dominate the market for shutting down the saphenous vein, which is the most important step in treating varicose veins. These techniques mercifully eliminated vein “stripping”, which required a visit to the hospital for general anesthesia. The only drawback to these techniques has been the need to inject large amounts of local anesthesia, which although done easily, is uncomfortable in some patients. This small group of pain-phobic individuals declined treatment altogether. Although they are a small percentage of the total number of individuals undergoing treatment, the actual numbers are very large and manufacturers continued seeking ways to obliterate the saphenous vein without using local anesthesia.
About two years ago, two techniques were introduced to address this issue. Surprisingly, neither ClariVein (a rotating paddle) nor Varithena (foam medication) has made dramatic inroads among doctors, in large measure because ClariVein is less pain free than expected, and Varithena is very expensive and has lingering safety issues.
The most recent entry into the arena is VenaSeal, a specially formulated glue. At the time I developed the radiofrequency idea in 1994 (I was the first to do this) I thought glue would be the ideal alternative to stripping, but alas I had no easy way to move forward. Years later others have gone on to create an effective product, and recently it received approval from the Food and Drug Agency (FDA). In many ways it could be the best of all, since it is completely painless and there are no safety issues. Bonus – after treatment there is no need to wear support stockings, as there is in the other four treatments discussed above.
The only impediment to widespread use of glue use is cost. Glue is quite expensive now and PPO insurances and Medicare have declined to cover its cost. That may take a couple of years. In the meantime you can indeed have glue closure of the saphenous vein, but you will have to pay cash. At this time I offer glue only to my wealthier and foreign patients, but you are welcome to inquire at any time.