Can varicose veins be sealed without heat?

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The Ache: Heat energy—either laser or radio-frequency—is often used to close painful and ugly varicose veins. But the popular technique requires injections into the leg of large amounts of anesthetic, resulting in multiple needle sticks and often pain, bruising and swelling after the procedure.

The Claim: Newer technologies, including a medical glue, can be used to seal the painful veins without heat, eliminating the need for anesthetic and allowing for faster recovery.

The Verdict: The new procedures, called nonthermal because they don’t use heat, have been shown in several studies to be as effective as lasers and radio-frequency treatments while offering advantages to patients, such as reduced bruising. Since the technologies are so new, however, published data is limited to only about two years of follow-up.

The glue product, called VenaSeal and sold by Medtronic PLC of Dublin, has “great short-term benefits for patients,” says Jennifer Watson, a vascular surgeon at Spectrum Health in Grand Rapids, Mich., who has done five of the procedures so far. Because VenaSeal only went on sale in the U.S. in November, “we don’t have a lot of experience with it and for some patients that’s a downside,” says Dr. Watson, who has no financial links to Medtronic. Following the glue injections, patients can return immediately to normal activities, she says, and they don’t have to wear compression stockings, which are commonly recommended for a week or two after other thermal or nonthermal procedures.

Varicose veins are gnarled, enlarged veins generally caused when valves leak and allow blood to flow backward. They can cause achy, throbbing legs and even lead to ulcers.

VenaSeal is applied in a half-hour procedure that involves using a hand-held dispenser to inject medical-grade glue into the great saphenous vein, a large vein that runs down the inside of the leg, Dr. Watson says. After it is closed, blood then flows through remaining healthy veins. The glue remains in the body and so far hasn’t been shown to cause any issues, says Mark Turco, chief medical officer for Medtronic’s aortic peripheral vascular business.

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