Steps of the Closure Procedure
Mapping the Saphenous Vein
A typical procedure begins with noninvasive ultrasound imaging of the diseased vein to trace its location. This allows Dr. Neimat to determine the site where the Closure catheter will be inserted and to mark the desired position of the catheter tip to begin treatment.
Inserting the Closure Catheter
After Dr. Neimat accesses the saphenous vein, the Closure catheter is inserted into the vein and advanced to the uppermost segment of the vein.
Dr. Neimat then injects a dilute anesthetic fluid into the area surrounding the vein.
This numbs the leg and provides a fluid layer outside the vein to protect surrounding tissue from heat once the catheter starts delivering RF energy. Saline is then slowly infused into the vein from the tip of the catheter to further create a near-bloodless field inside the vein, allowing the catheter to heat the vein wall, rather than the blood.
Steps Two and Three:
Delivering RadioFrequency(RF) Energy and Withdrawing the Catheter
Noninvasive ultrasound is used to confirm the catheter tip position and the physician then activates the RF generator, causing the electrodes at the tip of the catheter to heat the vein wall to a temperature of 85 degrees Centigrade or 185 degrees Fahrenheit. As the vein wall is heated, the vein shrinks and the catheter is gradually withdrawn. During catheter pullback, which typically occurs over 15 to 18 minutes, the RF generator regularly adjusts the power level to maintain target temperature to effectively shrink collagen in the vein wall and close the vein.
Confirming the Closing of the Vein
After treatment, ultrasound imaging is used to confirm closing of the vein. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. Following the procedure, a simple bandage is placed over the insertion site and additional compression is provided to aid healing. You are encouraged to walk, and to refrain from extended standing and strenuous activities for a short period of time. Patients who undergo the Closure procedure typically resume normal activities within a day.