Doctor has new remedy for varicose veins

Dr. Peter Lawrence, UCLA's chief of vascular surgery, picks up size 7 crochet hooks from a fabric store- not to make sweaters but to use in a new technique he has developed to treat varicose veins.

Early results of the new outpatient procedures, called lightassisted stab phelbectomy or LASP, appeared in a study in the October issue of The American Surgeon.

More than 250 patients at UCLA have undergone the procedure, which is designed to remove branch varicose veins from the thighs, calves and ankles.

The technique combines two current varicose vein-removal methods which excise veins through a small incision in the skin. Lawrence's method also employs transillumination, in which a light source is placed beneath the skin to help highlight the veins during the procedure.

In addition, Lawrence has developed new, minimally invasive surgical instruments to remove the veins.

"This new sutureless technique allows complete and rapid varicose branch vein removal with few missed varicose veins, little bruising and an excellent cosmetic result," said Lawrence, author of the study and a professor at the David Geffen School of Medicine at UCLA.

Varicose veins affect more than 40 percent of the adult population, mostly women. The inherited condition occurs frequently in the legs, where weakened valves in the veins lack the strength to push blood back to the heart, allowing it to pool in the lower extremities.

During the LASP procedure, in which the patient is sedated but remains conscious, Lawrence makes a tiny incision near the varicose veins and threads a slender tube with a light source at its tip underneath the vein cluster.

A liquid mixture is infused into the area, providing further anesthetic and plumping up the veins so that they are easily visible. The lights of the operating room are turned off so that Lawrence can see the veins illuminated under the skin.

Lawrence then makes a minute incision immediately adjacent to a varicose vein. Using a crochet hook that has been modified for the procedure, he hooks a vein, pulls it through the skin, grasps the vein with a tiny clamp and dislodges it.

The empty vein channels are flushed with solution to help collapse them and prevent bruising. A dressing is applied, and, within an hour, the patient goes home with instructions to elevate the leg for two days.

Researchers found few early postoperative complications, such as infection or severe pain.

According to Lawrence, LASP may provide lower residual varicose vein occurrence due to the greater ease in identifying the veins through transillumination.

Other study authors include Dr. Andrew J. Vardanian and Huynh L. Cao of the vascular surgery division at UCLA. The study involved no outside funding.

This story is provided by UCLA News.