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Answers to questions about vein disease, and treatments for varicose veins and venous leg ulcers


What is chronic venous insufficiency?

Healthy leg veins have valves that keep blood flowing to the heart. Chronic venous insufficiency develops when the valves stop working properly and allow blood to flow backward (i.e., reflux) and pool in the lower leg veins. If vein disease is left untreated, symptoms can worsen over time. As a result, vein valves will not close properly, leading to signs and symptoms such as:1

  • Varicose veins
  • Aching or pain
  • Swelling
  • Cramping
  • Heaviness or tiredness
  • Itching
  • Restlessness
  • Skin changes
  • Brown, colored skin
  • Open sores or ulcers

How prevalent is chronic venous insufficiency?

  • Varicose veins, a common symptom of CVI, can affect up to 40 percent of adults.4
  • Varicose veins are more common in those who are overweight, and in women who have had more than two pregnancies.4
  • Women usually have multiple risk factors for the development of varicose veins. In fact, varicose veins are most common in women (75 percent of those diagnosed) than in men (25 percent of those diagnosed).5
  • It is common for varicose veins to become more prominent during pregnancy and worsen with successive pregnancies.6

How is chronic venous insufficiency treated?

Chronic venous insufficiency treatment aims to reduce or stop the backward flow of blood. Treating the diseased vein improves overall blood flow.

For some patients, compression stockings alone may improve blood flow. For other patients, closing or removing the diseased vein may be necessary to improve blood flow. Closing or removing the diseased vein directs blood to nearby healthy veins.


What is the VenaSeal closure system?

The VenaSeal™ closure system uses a medical adhesive to close the diseased vein.

What does it treat?

The VenaSeal closure system treats symptomatic vein disease in the lower extremity superficial truncal veins, often the underlying cause of painful varicose veins.

What can I expect of the VenaSeal procedure?

Before the Procedure:

An ultrasound imaging exam of the leg that is to be treated will be arranged.  This exam is important for assessing the diseased superficial vein and planning the procedure.

During the Procedure:

The doctor can discuss the procedure with the patient. A brief summary of what to expect is below:

  • Some minor pain or stinging may be felt due to a needle stick to numb the site where the doctor will access the diseased superficial vein.
  • Once the area is numb, the doctor will insert the catheter (i.e., a small hollow tube) into the leg. Some pressure may be felt from the placement of the catheter.
  • The catheter will be placed in specific areas along the diseased vein to deliver small amounts of the medical adhesive. A mild pulling sensation may be felt. Ultrasound will be used during the procedure to guide and position the catheter.
  • After treatment, the catheter is removed and a small adhesive bandage placed over the puncture site.

After the Procedure:

  • Patients are taken to the recovery area to rest.
  • The doctor will recommend follow-up care as needed.

Returning to normal activity

The doctor can help determine when the patient can return to normal activity.

What happens to the VenaSeal adhesive?

Only a very small amount of VenaSeal adhesive is used to close the vein. The body will naturally create scar tissue around the adhesive over time to keep the vessel permanently closed.

How does the VenaSeal procedure differ from thermal energy procedures?

The VenaSeal procedure uses an adhesive to close the superficial vein. Thermal energy procedures use heat to close the vein. The intense heat requires a large volume of numbing medicine, which is injected through many needle sticks. The injections may cause pain and bruising after the procedure.


How quickly can I resume normal activity?

For a few weeks following the treatment, the vein specialist may recommend a regular walking regimen and suggest refraining from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.

How is the ClosureFast procedure different from vein stripping?

During vein stripping, incisions are made in the groin and calf, and a tool is threaded through the diseased vein to pull the vein out of the leg. With the ClosureFast procedure, only one small incision is made at the insertion site and the vein is then treated and left in place. 10


Johns Hopkins Medicine Health Conditions and Diseases. Available at: Accessed May 14, 2019.


Gloviczki, P, Comerota, A, Dalsing, M, Eklof, B, Gillespie, D, Gloviczki, M, et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May; 53 (5 Suppl): 2S-48S.


US Markets for Varicose Vein Treatment Devices 2011, Millennium Research Group. 2011.


Tisi, P. Varicose veins. Clin Evid (Online). 2011.


American College of Phlebology. Patient FAQs.


American College of Phlebology. Treatment of varicose and spider veins. Varicose_Vein_Brochure_Redesign.pdf


Morrison, et al. VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins. J Vasc Surg


Almeida, J.I.,Kaufman, J., Göckeritz, O., et al. Radiofrequency endovenous ClosureFast versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY Study). J Vasc Interv Radiol. 2009;20:752-759.


L. H. Rasmussen, M. Lawaetz, L. Bjoern, B. Vennits, A. Blemings and B. Eklof, Randomized Clinical Trial Comparing Endovenous Laser Ablation, Radiofrequency Ablation, Foam Sclerotherapy and Surgical Stripping for Great Saphenous Varicose Veins. British Journal of Surgery Society Ltd., Wiley Online Library,, March 15, 2011


Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, et al. Prospective randomized study of endovenous radiofrequency obliteration. (Closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study). J Vasc Surg 2003;38;2:207-14.