Vanishing Veins

By Julie Kirkwood
Staff Writer

Varicose veins run in Mary Cormier's family, so she wasn't surprised this past year when veins began to bubble up like a grape cluster on her right leg. "It's just a natural progression in life," she said.

When her doctor noticed the veins at a checkup, though, he suggested she get them checked out by a surgeon. They hurt if she brushes them against a table leg, she said, and her leg feels heavy sometimes when she walks or runs.

Surgery to treat varicose veins is no longer the ordeal it used to be. New treatments developed in the past five years make it possible for doctors to do the surgery in an office setting without general anesthesia.

It has become so simple that at least two clinics have opened North of Boston in the past few months combining varicose vein surgery with basic cosmetic surgery to treat spider veins, a condition related to varicose veins but without medical consequences.

Parkland Medical Center in Derry opened the Vein and Laser Center of New Hampshire last week. A group of private-practice surgeons affiliated with Salem, Mass., and Beverly hospitals opened the Vein Institute of the North Shore recently at the Cummings Center in Beverly.

Surgeons say they expect the new techniques to bring in a wave of patients who have been avoiding surgery because they were afraid of the operating room.

"My vein practice has grown by word of mouth considerably," said Dr. Larry P. Goldberg, a vascular surgeon at the Beverly clinic. "I really do think it's the noninvasive nature of the procedure."

Cormier, who lives in Chester, N.H., first decided to try treating her varicose veins by wearing support hose, which effectively controls symptoms for many people.

After two months, though, she decided to give surgery a try.

"You can go without an operation, definitely, and the doctor told me that you can do that," Cormier said, "but the veins can get worse, and if they get worse, then they really can start to get into problems."

More than 80 million Americans have varicose veins, spider veins or a related vein disorder, according to the American College of Phlebology. As many as half of all women will develop vein problems, often only temporarily during pregnancy.

Varicose veins arise when blood vessels in the leg have trouble pumping blood up toward the heart. Often this happens because of damage or leaks in the valves that are supposed to prevent backflow, said Dr. Paula Muto, a vascular surgeon in Lawrence.

As a result, blood pools in the leg veins. If the veins are relatively big, the pooled blood can make them bubble up into varicose veins. If the veins are smaller and closer to the skin surface, they become benign red or blue squiggles known as spider veins.

For years, the standard surgery to treat varicose veins, called vein stripping, was done in a hospital operating room under general anesthesia. The surgeon made an incision in the groin and used an instrument to pull out the offending vein, which runs along the inner thigh down to the knee.

The surgery now can be done in a doctor's office through an incision near the knee. The surgeon slides a laser through the vein and collapses it, rather than removing it. One of the manufacturers of such lasers, Diomed, is based in Andover.

Many patients require a follow-up surgery afterward to get rid of the bumps, but typically 90 percent to 95 percent of the veins can be cleared up, said Dr. Normand Miller, the vascular surgeon at the new clinic in Derry.

"It's unusual that you cannot eliminate all of those bumpy veins," he said.

Varicose veins, if left untreated, can cause pain, fatigue, aching, burning, throbbing, itching and cramping. In severe cases, they can lead to eczema on the skin, inflammation or a skin wound.

Even surgery does not protect a patient from the symptoms forever.

"While surgical treatment for varicose veins is effective and safe, veins can always come back," Muto said.

It hasn't been long enough for Cormier to know if her surgery worked, but two days after, she said her leg already felt different.

"I didn't do this for looks," Cormier said. "I did this because I want to avoid serious trouble down the road."