Beyond the Cosmetics of Vein Repair
Date: September 17, 2010
For Keith Ross, treatment success meant a long-awaited return to the luxuries of a bathtub. “Yep,” says the former longshoreman. “Eight years, all I could take was showers.”
The reason? An ulcer on his leg that had been deemed untreatable.
“There are a lot of myths about venous disease,” says vascular surgeon Jennifer Heller, who launched the Johns Hopkins Vein Center in 2005. Easily 90 percent of her 1,400 patients in the past year came seeking help for issues that went far beyond the cliches of cosmetics. Many are dealing with lower-extremity edema, ulcers, venous stasis dermatitis, lingering fatigue and chronic pain. Sometimes the symptoms are so severe that patients—especially if they’re firefighters, police officers, teachers and others who must be on their feet—often become unable to perform their job duties.
What brought Keith Ross to the Vein Center, says Heller, began as a small wound he’d sustained on his outer left calf after a minor household incident. The injury blossomed into a full-blown ulcer, propelling Ross, now 47, into a frustrating cycle of healing attempts at a local wound center.
But even the wound center’s best efforts wouldn’t hold. Each time the wound opened up again, says Ross, he felt like more of the site’s nerve endings became exposed. The pain got to him. “I took so much pain medicine that it was crazy,” he says.
By the time he arrived at Heller’s office, doctors had begun thinking Ross was simply abusing pain medicines. “People called him a drug addict,” says Heller, who assessed and treated Ross in November 2009.
After evaluation, Heller determined that Ross’s ulcer was due to chronic venous insufficiency. To improve his venous circulation, she used a radiofrequency technique called endovenous ablation that’s deployed via catheter and threaded through the vein’s injured areas.
The procedure, says Heller, heats the venous walls and forces the tissue to respond by generating collagen, which in turn strengthens the venous walls. The 30-minute outpatient procedure eventually healed Ross’s long-festering ulcer. Heller says she has successfully used this ablation technique with more than 800 patients.
Ross reports that his calf still swells sometimes, and for that Heller prescribes compression stockings. Otherwise, Ross says, “I’m fixed. I don’t need pain medicine anymore.”