• This page will give you an insight into the VNUS closure procedure. Please feel free to print it off and take it home with you. We hope to continually improve our service so don't hesitate to get in touch. We welcome any feedback particularly if your experience is different from the one described here. I've added a link to the VNUS web site as well as some animated footage of the procedure. VNUS

The VNUS Closure Procedure^®

Veins: The Anatomy

Veins return blood to the heart. In the lower limb they achieve this through two main venous systems, the deep system and the superficial system. The Deep System is a high pressure system within the muscle and fascial envelope of the leg. The Superficial System is a lower pressure system, closer to the surface of the leg and just beneath the skin and its supporting structures. These two systems connect to each other at the groin, behind the knee and via perforating veins throughout the leg.  Valves within the veins ensure flow within the leg back towards the heart and protect the superficial system from the high pressures in the deep system. 

Varicose veins: The Problem

When the valves fail, particularly at the connection between the two systems this leads to increased pressure in the superficial system. The increased pressure causes the vein to dilate and become varicose. In the groin this happens at the sapheno-femoral junction and behind the knee at the sapheno-popliteal junction. The increased pressure in the superficial veins is transmitted to the leg producing symptoms of pain, swelling and discomfort. Over time the pressure changes in the leg lead to skin changes known as varicose eczema which may eventually lead to ulceration.

VNUS: The Solution (Closure Procedure)

The VNUS Closure procedure^® is a relatively new, exciting but well established procedure, specifically designed for the treatment of varicose veins. The procedure uses a thin catheter inserted via a 2-3mm incision in the skin. The catheter is inserted into and placed exactly at the right level within the vein using ultrasound control.  The tip of the catheter is modified to deliver radio frequency energy to the vein wall. This radiofrequency energy heats the vein causing it to shrink immediately, sealing the vein shut.

VNUS: The Procedure Pathway

Before: On arrival at the clinic you will be shown to the waiting area by the nursing staff. If appropriate you will be offered refreshments and taken to an area where you can change into a theatre gown. This is for your own comfort and to allow access to the affected leg. You will be able to keep on your under garments at all times. The nursing staff will be free to answer questions at any time so feel free to ask. Once changed, the surgeon will mark the leg and discuss the procedure once more finalising the consent process. At this time and to aid the local anaesthetic Emla^®  cream may be applied to your leg over the vein. After thirty minutes you will be taken to the treatment room and asked to lie on the bed. You can choose music to listen to and talk freely to the staff if you wish.

During: The surgeon will identify the vein in the thigh and insert a small amount of local anaesthetic. This is to allow insertion of the catheter. Once the catheter is positioned the bed will be tilted to empty the vein. More local anaesthetic to surround the catheter. Manual pressure is applied to the catheter and vein twenty seconds at a time during the treatment phase. After the procedure, small steri-strips, bandages and stockings will be applied to the treated leg.

After: The whole process should take forty to sixty minutes and patients should be able to mobilise immediately. The wound should be kept dry for three days and the stocking worn for a minimum of two weeks. This makes the treatment more effective and reduces the risk of deep vein thrombosis. The stocking can be removed to shower but put back on immediately after. The steri-strips usually fall off in the shower but if not they can be removed after day five. Pain killers are not usually required but if needed ibuprofen and paracetamol usually suffice. It's important to walk half an hour morning and evening. There are no restrictions on exercising or activity provided the stocking is worn for two weeks.

VNUS: The Results / Risks

The procedure is extremely well tolerated and therefore performed as a day case. There is less pain and less risk of complications when compared to conventional treatments. Patients recover quickly often being able to return to work within 24-48hrs. There is no need for a general anaesthetic thereby reducing the risk of deep vein thrombosis and anaesthetic related complications. As with any procedure complications do exist and although rare include deep vein thrombosis, phlebitis, bleeding, infection, thermal (burns) and neurological (numbness) injury. Please remember these complications are extremely rare but if you have any concerns please discuss them with a member of staff.