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A Different Vein
Better technology gives the Johns Hopkins Bayview Vein Center a leg up.


Jennifer Heller with her team, including Kristine Smith, far right, who had the procedure.
Jennifer Heller with her team, including Kristine Smith, far right, who had the procedure.

For years, varicose veins seemed the neglected stepchild of vascular surgery, says Jennifer Heller. After all, notes the vascular surgeon and medical director of the Johns Hopkins Bayview Vein Center, when compared with other vascular conditions such as aortic aneurysms, limb salvages and strokes, varicose veins seem decidedly less urgent. But, she adds, physicians are gradually recognizing the physical and emotional pain that venous reflux causes, and they’re treating the disease accordingly.

Just as arteries carry blood away from the heart, veins direct the blood back again. Varicose veins, also called venous reflux, occur when a malfunction causes blood to collect in the veins. If it goes untreated, the condition causes the veins to swell, eventually resulting in painful sores and ulcers on the leg. “It can be very debilitating,” Heller explains. “The majority of my patients are school teachers and nurses and factory workers who spend so much time on their feet. Eventually they can barely stand up, and they all say the same thing: It really is unbearable.”

Until about eight years ago, the primary surgery used for removing varicose veins was a long painful procedure called vein stripping, which required large incisions in the groin and leg, and a lengthy recovery time. But in recent years, minimally invasive options have become available, offering the same results with less pain and time. The procedure usually takes about an hour.

Kristine Smith, a nurse on Heller’s team, was plagued with varicose vein discomfort from 12 years of being a nurse and two pregnancies. Having scrubbed in on the procedure many times, she knew exactly what to expect. Smith, 36, had the operation last May. “I don’t think people realize how easy it is,” she says. “You not only feel better; you get to enjoy the cosmetic aspect, and most insurance companies cover it.” The week after surgery, Smith was back at her spinning class and has scheduled the procedure for her other leg.

Since the center opened in November 2006, the hospital has seen a 40 percent increase in the number of patients treated for varicose veins. “Before the center opened, I realized I was seeing more and more varicose vein patients in my practice,” Heller recalls. “We just couldn’t get all of these cases done in the main operating rooms. I thought that if we built a dedicated vein center, more patients would come and we’d gain expertise in the art of taking care of them.”

Funded by the Johns Hopkins Department of Surgery, the center has its own anesthesiologist, radiologist, OR nurse and fully equipped operating room, allowing Heller to schedule surgeries without worrying about space or staff availability. Best of all, the center provides patients with continuous care by offering a centralized location to turn to should they have any questions.

Even so, Heller says, there is still little research regarding varicose veins, something Heller and her team aim to change. They’re currently conducting outcomes studies about the quality of life for patients after minimally invasive vein surgery. “We’re the only academic medical center in the state focusing on venous disease,” Heller says. “The vein center has really been a labor of love.”

—Lauren Manfuso



Johns Hopkins Medicine

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