Venaseal - Non-thermal Glue Ablation - Dr Sahaja Vascular Surgeon

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Venaseal - Non-thermal Glue Ablation

Introduction / Overview

Venaseal is an innovative, minimally invasive treatment for varicose veins that uses a medical adhesive to close diseased veins without the need for heat or thermal energy. Unlike traditional thermal ablation techniques such as radiofrequency or laser ablation, Venaseal employs a proprietary cyanoacrylate glue to seal the vein, offering a less painful and quicker recovery option. This non-thermal glue ablation method is gaining popularity due to its effectiveness, reduced post-procedural discomfort, and elimination of the need for tumescent anesthesia. Understanding Venaseal is important for patients and healthcare providers seeking advanced, patient-friendly solutions for chronic venous insufficiency and varicose veins.

Anatomy / Background

The venous system in the legs consists of superficial veins, deep veins, and perforator veins that connect the two. The great saphenous vein (GSV) and small saphenous vein (SSV) are the main superficial veins commonly affected by varicosities. Healthy veins have one-way valves that prevent blood from flowing backward. When these valves become incompetent, blood pools in the veins, causing them to enlarge and become varicose. This condition is known as chronic venous insufficiency (CVI). Understanding the anatomy of the venous system is crucial for targeting the diseased veins during treatment.

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Causes / Etiology

Several factors contribute to the development of varicose veins and venous insufficiency:

Genetics: Family history is a strong risk factor.
Age: Vein valves weaken with age.
Gender: Women are more prone due to hormonal influences.
Pregnancy: Increased blood volume and pressure on veins.
Obesity: Excess weight increases venous pressure.
Prolonged standing or sitting: Leads to venous stasis.
Previous leg injuries or surgeries: Can damage veins or valves.
Deep vein thrombosis (DVT): May cause valve damage.

Symptoms / Clinical Presentation

Patients with varicose veins often present with:

Visible, bulging, twisted veins on the legs.
Aching, heaviness, or throbbing sensations.
Swelling in the lower legs and ankles.
Itching or skin irritation around the affected veins.
Cramping or restless legs, especially at night.
Skin discoloration or ulcers in advanced cases.

Diagnosis

Diagnosis of venous insufficiency and varicose veins involves:

Clinical Examination: Inspection and palpation of the legs to identify visible varicosities and assess symptoms.
Duplex Ultrasound: The gold standard imaging technique that evaluates vein anatomy, valve function, and blood flow direction.
Venography: Rarely used, invasive imaging for complex cases.
Photoplethysmography or air plethysmography: Non-invasive tests to assess venous function.

Treatment Options

Treatment depends on the severity of symptoms and vein involvement:

Non-Surgical Treatments

Surgical and Procedural Treatments

Thermal Ablation: Radiofrequency or laser ablation to close veins using heat.
Sclerotherapy: Injection of sclerosant to obliterate smaller veins.
Phlebectomy: Surgical removal of varicose veins.
Venaseal (Non-Thermal Glue Ablation): Uses medical adhesive to seal the vein without heat.

Procedure Details: Venaseal Non-Thermal Glue Ablation

Ultrasound Guidance: The diseased vein (usually GSV or SSV) is identified and accessed with a catheter.
Catheter Insertion: A small catheter is inserted into the vein through a tiny puncture.
Adhesive Delivery: The proprietary cyanoacrylate glue is injected through the catheter as it is slowly withdrawn, sealing the vein walls together.
No Heat or Tumescent Anesthesia: Unlike thermal methods, no heat or multiple needle injections for anesthesia are required.
Immediate Closure: The vein is permanently closed, redirecting blood flow to healthy veins.

Postoperative Care / Rehabilitation

Patients can usually walk immediately after the procedure.
No need for compression stockings in most cases, though some doctors may recommend them for a short period.
Mild soreness or tenderness may occur but generally resolves quickly.
Normal activities can be resumed within a day or two.
Follow-up ultrasound is performed to confirm vein closure.
Patients are advised to avoid strenuous exercise for about a week.

Risks and Complications

Venaseal is generally safe, but potential risks include:

Phlebitis: Inflammation of the treated vein.
Allergic Reaction: Rare sensitivity to the adhesive.
Deep Vein Thrombosis (DVT): Very rare but serious.
Skin Discoloration or Staining: Temporary in some cases.
Nerve Injury: Uncommon, depending on vein location.
Incomplete Closure or Recurrence: May require retreatment.

Prognosis

Venaseal offers excellent long-term outcomes with vein closure rates comparable to thermal ablation. Patients experience less pain and faster recovery. Most report significant symptom relief and improved quality of life. Recurrence rates are low, and the procedure can be repeated if necessary.

When to See a Doctor

Visible varicose veins with pain, swelling, or skin changes.
Leg ulcers or non-healing wounds.
Sudden leg swelling, redness, or warmth (possible DVT).
Symptoms interfering with daily activities.
Concerns about cosmetic appearance or discomfort.

Conclusion

Venaseal represents a breakthrough in the treatment of varicose veins by offering a non-thermal, minimally invasive option that reduces pain and recovery time. Understanding the anatomy, causes, symptoms, and treatment options empowers patients to make informed decisions. If you suffer from varicose veins or chronic venous insufficiency, consult a vascular specialist to explore whether Venaseal or other therapies are right for you. With advances like Venaseal, relief from varicose veins is safer, easier, and more effective than ever before.

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