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Varicose Veins


Varicose veins are enlarged, swollen, and twisting veins, often appearing blue or dark purple. They happen when faulty valves in the veins allow blood to flow in the wrong direction or to pool.

Aging: As you age, veins grow weaker and become more at risk.
Gender: Women are more likely to develop vein disease; however it is not uncommon for a man.
Heredity: Genetics is the number one contributing factor for developing vein disease.
Lifestyle: Sitting or standing for long periods of time strain veins.
Obesity: Being overweight can put excessive pressure on your veins.
Pregnancy: Pregnancy increases your risk for developing varicose veins.

If you have varicose veins or experience leg pain and fatigue, you may have venous reflux disease. Venous reflux disease is a progressive medical condition and if left untreated, may worsen over time and develop into a more serious form of venous disease called chronic venous insufficiency. Don’t wait for your varicose veins to become something worse. Schedule an appointment today with Dr. Vishal Rekhala or Dr. Richard Dentico to diagnose if your health is at risk.
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Meet Our

Vein Procedures Team
Vishal P. Rekhala, D.O.
Richard Dentico, M.D.

See What Patients Are Saying About the Vein Center at Orthopedic Associates

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Venous Reflux Disease: Why Treatment Matters



Frequently Asked Questions

The ClosureFast™ procedure is a minimally invasive treatment that uses radiofrequency (RF) energy to effectively treat patients with varicose veins or chronic venous insufficiency (CVI). Because the valves in the legs cannot be repaired, the only alternative is to re-route the blood flow from the diseased veins to the healthy veins.

To do this, a vein specialist inserts a catheter into the diseased vein through a tiny incision below the knee. Guided by ultrasound imaging, Dr. Rekhala will treat the vein in 7 cm segments for 20 seconds each. The catheter delivers consistent and uniform heat to contract the collagen in the vein walls, causing them to collapse and close. After the vein is sealed shut, blood is then naturally redirected to healthy veins. The treated vein then becomes fibrous tissue and will gradually be absorbed into surrounding tissue.

The ClosureFast™ procedure has been shown in a large multicenter study to be 94.9% reflux-free at 5 years. Treating with the ClosureFast™ catheter resulted in high closure rates with improvements in CEAP Class grading and VCSS out to 5 years post treatment. The ClosureFast™ procedure has been shown in a large multicenter study to be 94.9% reflux-free at 5 years. The RECOVERY Study showed that patients experience less bruising and pain, and fewer complications with the ClosureFast™ procedure, using the Medtronic ClosureFast™ endovenous radiofrequency ablation (RFA) catheter in comparison to 980 nm laser ablation.

The ClosureFast™ procedure is performed as a medical necessity as diagnosed by a trained vein specialist, such as Dr. Rekhala. It is not designed to address spider veins or cosmetic issues. As with any medical procedure, you should consult a vein specialist and review all safety information associated with the procedure.

Many insurance companies pay for the ClosureFast™ procedure in part or in full. The ClosureFast™ procedure has coverage policies with major health insurers. Dr. Rekhala can discuss your insurance coverage further at the time of consultation.
Vein stripping is a surgical procedure. The surgeon makes an incision in your groin and ties off the vein, after which a “stripper” tool is threaded through the leg vein in order to pull it out through a second incision just above the calf. Bruising and swelling often occur post-procedure and nerve tissues surrounding the treated vein can be damaged, causing numbness or burning around the site.

The ClosureFast™ procedure is minimally invasive. In contrast to vein stripping, the vein remains in place and is closed using a special catheter inserted through a small incision below the knee.

Vein stripping is usually performed in an operating room under a general anesthetic, while the ClosureFast™ procedure is often performed in an outpatient setting, typically using local or regional anesthesia.
The ClosureFast™ procedure utilizes radiofrequency energy to provide consistent and controlled heat to contract the collagen in the vein walls, causing them to collapse and seal. Once a leg vein is closed, blood flow is redirected to healthy veins.
Laser ablation uses laser heat to collapse and seal the affected vein. The laser targets blood in the vein, causing it to heat. This heat creates a steam bubble inside the vein, causing damage to the vein so that it collapses. Unlike the ClosureFast™ procedure, laser temperatures can reach over 1200⁰C, which can lead to increased bruising and post-procedural pain for the patient. Animal studies have shown that laser can potentially lead to perforation and destruction of the vein walls, causing significantly more bruising and post-procedure pain for patients.

The RECOVERY Study compared the experience of patients treated with the ClosureFast™ procedure and those treated with 980 nm laser ablation. The findings clearly demonstrated that the ClosureFast™ procedure resulted in less pain, less bruising, and fewer complications.

In the RECOVERY Study, the author concluded, “RF thermal ablation (ClosureFast™ procedure) was significantly superior to laser ablation as measured by a comprehensive array of post-procedural recovery and quality of life parameters in a randomized prospective comparison between these two thermal ablation modalities for closure of the Great Saphenous Vein.”
The ClosureFast™ procedure takes approximately 45-60 minutes. Most patients typically spend two to three hours at the medical facility due to normal pre- and post-treatment procedures.
The ClosureFast™ procedure can be performed under local, regional or general anesthesia. It is generally performed using local anesthesia in our office or an outpatient surgical facility.
Many patients experience a quick return to normal activities, typically within a few days. For a few weeks following the treatment, a Dr. Rekhala may recommend a regular walking regimen and suggest you refrain from very strenuous activities (i.e., heavy lifting) or prolonged periods of standing.
Most patients report a noticeable improvement in their symptoms within one to two weeks following the procedure. For any cosmetic symptoms that are not completely resolved following the procedure, you may consider adjunctive treatment including sclerotherapy (small chemical injections) or micro phlebectomy (removal of varicose veins through small skin punctures under local anesthesia).
As with any medical intervention, potential risks and complications exist with the ClosureFast™ procedure. Dr. Rekhala will have a consultation with you to determine if your conditions present any special risks. They will also review with you potential complications associated with the ClosureFast™ procedure, which can include but not limited to the following: adjacent nerve injury, hematoma, pulmonary embolism, thrombosis, infection, phlebitis, skin burn or discoloration, or vessel perforation.

Patients report minimal to no scarring, bruising or swelling following the ClosureFast™ procedure.
Dr. Rekhala can tell you if the ClosureFast™ procedure is the right option for your vein problem. Experience has shown that many patients with chronic venous insufficiency can be treated with the ClosureFast™ procedure.
The most important step in determining whether or not the ClosureFast™ procedure is appropriate for you is a complete ultrasound examination by Dr. Rekhala. Age alone is not a factor in determining whether or not the ClosureFast™ procedure is appropriate for you. The ClosureFast™ procedure has been used to treat both women and men across a wide range of ages.

Posted in on January, 2022