VenaSeal Procedure
in Los Angeles

Minimally Invasive
Varicose Vein Treatment

Woman running after getting VenaSeal treatment in Los Angeles

The VenaSeal procedure is a unique method of varicose vein treatment that has distinct advantages over other treatment options, specifically when it comes to patient comfort and post-procedure recovery. In this article, the vein specialists at ProVascularMD provide a rapid review of how VenaSeal works and how its technical features might provide a better patient experience than other vein treatment options.

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What is VenaSeal?
How does VenaSeal work?
What to expect during the VenaSeal procedure?
How does VenaSeal compare to other vein treatment options?
Is VenaSeal right for me?

Vein Specialist Dr. Michael Lalezarian in Los Angeles, California

Vein Specialist

Dr. Michael Lalezarian

Vein problems? We can help you get your legs back.

Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in minimally invasive vein treatments. He is a committed partner in the battle against the devastating consequences of venous insufficiency.

5-Star Varithena treatment in Los Angeles

“I was referred to Dr. Lalezarian from my orthopedic surgeon for varicose vein treatment options. From the second I walked into the office, I was at ease and felt very welcomed from Kimberly and the staff. Upon meeting the doctor, he was so kind and fully explained my options after the initial ultrasound on both legs. I decided to go with the sclerotherapy and am so happy that I did. The procedures were quick and virtually painless but the results are life changing for me. The pain suffered for so many years and countless sleepless nights are a thing of the past.”

Vickie W, March 2022

What is VenaSeal?

VenaSeal is a bio-adhesive ‘glue’ that’s designed for use in the veins. It was approved by the FDA in 2015 for the treatment of adults with clinically symptomatic venous reflux / varicose veins. [1] Like other varicose vein treatments, the goal of a VenaSeal procedure is to permanently close down diseased veins. [2]

How Does VenaSeal Work?

The VenaSeal adhesive is an n-butyl-2-cyanoacrylate (NBCA) based formulation. The chemistry behind the device is similar to other bio-adhesives used to close surgical incisions, wounds, and lacerations. Kept isolated, the VenaSeal solution is a clear, sterile, free-flowing liquid. Upon contact with bodily fluids, such as blood inside the vein, the individual molecules of NBCA begin to polymerize. Within minutes, this creates a solid material within the vein, which then becomes surrounded by fibrous tissue, creating a durable occlusion. [1]

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VenaSeal procedure provided by ProVascularMD in Los Angeles

What to Expect During the VenaSeal Procedure?

The VenaSeal procedure can take anywhere from thirty to sixty minutes, depending on the length of the vein needing treatment. The procedure begins with a tiny puncture in the leg, where a catheter is then inserted into the vein. The catheter is navigated to the highest segment of the varicose vein and the VenaSeal adhesive is injected, followed by a brief period of compression. Once the initial segment of the vein is sealed, the adhesive is injected into the next segment of the vein, and this process is repeated for the full length of the varicose vein.

How Does VenaSeal Compare to Other Treatments?

No Heat, No Tumescence, Fewer Needlesticks

Until recently, thermal ablation devices, such as radiofrequency and laser treatment, were the ‘gold standard’ for minimally invasive varicose vein treatment. Thermal devices work by applying short bursts of focused heat to the inside of the vein that causes the vein to collapse. Many medical procedures are destructive in nature, so patients shouldn’t find this type of approach alarming. However, thermal treatment does require certain safeguards to protect patients from the adverse effects of extreme heat – one of which is the use of tumescent anesthesia. Tumescent anesthesia is a liquid that numbs the treatment area while providing a heat-conducting medium for the safe delivery of thermal energy. [3] Covering the entire length of a vein with anesthesia often requires several uncomfortable needlesticks.

In contrast, VenaSeal is entirely non-thermal and does not require tumescent anesthesia. This generally means fewer needle sticks for patients and a more comfortable procedure. Readers should note that Varithena foam sclerotherapy offers many of the same advantages as VenaSeal, which is why our vein specialists offer both treatments here at ProVascularMD.

Immediate Recovery & Return to Normal Activities

The non-thermal nature of VenaSeal can also make it easier for patients to return to work and resume moderate exercise immediately following their procedure. With thermal ablation, on the other hand, it can take patients a few days to fully recover from thermal ablation. This point is further emphasized in human studies directly comparing a VenaSeal procedure to thermal ablation, which has demonstrated that treatment with VenaSeal sees less post-procedural pain and bruising than treatment with thermal ablation. [5]

No Compression Stockings

Medical-grade compression stockings have long been an integral part of minimally invasive vein treatment. Stockings help to manage post-operative pain, reduce the risk of procedure-related complications, and help to ensure vein closure. [8] Unfortunately, medical stockings are notorious for being uncomfortable, and failing to follow post-procedure stocking protocols may compromise the vein treatment recovery process.

Real-world registry data has demonstrated that compression stockings may not be necessary with VenaSeal. [4,5] However, depending on the extent of disease, we may still encourage the use of compression stockings following the procedure to ensure the best results.

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Explanatory VenaSeal procedure graphic
Graphic of Venaseal being deployed inside the vein to seal the vein shut.

Similar Clinical Outcomes

Clinically speaking, the goal of varicose vein treatment is to permanently close the target vein and relieve the uncomfortable symptoms associated with varicose veins. Many patients ask which vein treatment is the most effective in this regard, or they may ask if VenaSeal is better or worse than other vein treatment options.

The best answer that we have to these questions comes from the VeClose study, a large study in which 222 patients were randomly assigned to either VenaSeal or radiofrequency thermal ablation. At one year, the study showed similar improvement of symptoms, and similar rates of vein closure between the two groups – both groups achieving success rates greater than 95%. [6] Three-year data were presented in London in April 2017, demonstrating similar efficacy between the two groups and addressing the lingering concerns about the long-term efficacy of VenaSeal. [7]

Is VenaSeal Right for Me?

In summary, the VenaSeal procedure is as effective as any other vein treatment option while potentially providing patients with a more comfortable experience and an easier post-procedure recovery. If you have questions about VenaSeal or any other other vein treatment options, get in touch with us at ProVascularMD. We offer individualized vein treatment at four dedicated vein centers in Los Angeles and surrounding cities.

Vein Treatment in Los Angeles
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More Resources
Stages of venous insufficiency

Stages of Venous Insufficiency

Learn about the stages of venous insufficiency, from spider veins to venous leg ulcers.
Venous leg ulcer treatment

Venous Leg Ulcer Treatment

Learn how minimally invasive vein treatments can help accelerate healing.
Los Angeles Vascular Specialist Dr. Michael Lalezarian

Vascular Specialist in Los Angeles

Learn more about Los Angeles Vascular Specialist Dr. Michael Lalezarian.

References

[1] Venaseal Closure System Product Code VS-402. PT – 11348-01 Rev D, 2015-02.
[2] Mark H Meissner (2016). What is Effective Care of Varicose Veins? Phlebology, 31(1), 80-87.
[3] Lohr, J., & Kulwicki, A. (2010). Radiofrequency Ablation: Evolution of a Treatment. Seminars in Vascular Surgery, 23(2), 90–100.
[4] Gibson K., and Ferris B. Cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of post-procedure compression: Initial outcomes of a post-market evaluation of the VenaSeal System (the WAVES Study) Vascular, 25(2):149-156.
[5] Thomas M. Proebstle et al. (2015). The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins J Vasc Surg: Venous and Lym Dis, 3(1), 2-7.
[6] Nick Morrison et al. (2017). VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins.Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5:321-30.
[7] Three-Year VeClose Data and 1-Year WAVES Data Presented for Medtronic’s VenaSeal Closure System. Endovascular Today. Web: https://evtoday.com/2017/04/three-year-veclose-data-and-1-year-waves-data-presented-for-medtronics-venaseal-closure-system
[8] Joh, J. H., Kim, W.-S., Jung, I. M., Park, K.-H., Lee, T., Kang, J. M., & Consensus Working Group. (2014). Consensus for the Treatment of Varicose Vein with Radiofrequency Ablation. Vascular Specialist International, 30(4), 105–12.

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