By FELIX CARROLL
Times Union

Tuesday, May 3, 2005

All told, Kelly Shear felt she barely had a leg to stand on.

Her varicose veins made her legs swell, ache and sting.

"My leg looked like an 80-year-old's," says Shear, 38, of Princetown. "I was unable to expose my legs in public. It was horrible."

Doctors still don't know why valves in some people's veins simply stop functioning, causing the telltale build up of blood and the ballooning of veins in the legs. But they now know how to make the veins disappear without intensive surgery.

Shear's legs are living proof. In December she underwent a procedure called Closure in which a tiny catheter is used to shrink and seal shut the vein through use of radio frequency energy. Lasers and injections are also used nowadays for similar results.

Following the procedure, blood flow automatically reroutes through other, healthy veins, and the treated veins eventually become absorbed by the body.

"I would recommend it highly," says Shear.

Perhaps because thoughts of bathing suits and Bermuda shorts hover on the horizon, spring is the season for many people to seek varicose vein treatment, says Frank Fort, a vascular surgeon and director of the Capital Region Vein Centre in Schenectady.

"Right now it's like Christmas," says Fort. In other words, his office is busy.

But the unsightliness of varicose veins is not always the reason people choose treatment, he says. Painful symptoms are more often the main impetus, he says.

Until five years ago, the most common method for treating varicose veins was to have them removed through a procedure known as stripping. In stripping, incisions are made at various points along the vein and the vein is removed in segments. The procedure performed less and less in favor of lasers, injection and more modern means often results in scars and a healing process that could take more than a month.

As for possible side effects with the newer procedures, Closure can cause temporary numbness, skin burns and inflammation. Sclerotherapy, which uses an injection of a special chemical sclerosant into a varicose vein causing the vein to close, can also result in some pain, a burning feeling and skin color changes along the treated vein. Such side effects are rare, says Fort.

"I was back to work in two days," says Jason Greski, 29, of Glenville, who recently underwent Closure treatment.

Most accounts of what causes varicose veins are mere folklore, physicians say. For instance, there is no proven link between varicose veins and diet, crossing the legs, constipation, tight garments, or sunbathing. Most physicians agree, however, that hereditary may play a role. Hormones may also play a role, which could explain why women, by nearly a 4 to 1 ratio, are more likely to be affected than men.

What is known for sure is that varicose veins occur when the valves that move blood to the heart cannot close properly. The result is that blood leaks downward and pools in the lower extremities causing the veins to bulge. The symptoms tend to worsen over time. Being on your feet can make the symptoms worse.

Varicose veins can sometimes lead to phlebitis (chronic inflammation of the vein), leg ulcers and even rupture of the vein.

Pain issue

Fort says he charges about $450 for Closure, which he performs at Bellevue Woman's Hospital in Niskayuna. He performs nonsurgical procedures, such as lasers and injections, at the Vein Centre for which he charges $175 a session. It may take two or three sessions, he says.

"For me, it wasn't a cosmetic issue," says Greski, who works on his feet all day long as a receiving manager in a retail store. "It was a pain issue. It was getting worse and worse. And now it's gone."