What is Varithena and How Does It Work?
Varithena, or polidocanol injectable foam, is an FDA-approved prescription medicine designed to treat symptomatic varicose veins caused by underlying issues in the great saphenous vein (GSV) system. Unlike traditional surgical procedures, Varithena is minimally invasive, utilizing a proprietary microfoam that is injected into the affected veins to cause them to collapse and be reabsorbed by the body. This process ultimately redirects blood flow to healthier veins, improving both the physical symptoms and the cosmetic appearance of varicose veins.
The Pharmacological Action of Polidocanol
At the heart of Varithena's effectiveness is its active ingredient, polidocanol, a non-ionic surfactant and sclerosing agent. The microfoam formulation is crucial to its action for several reasons:
- The foam consistency displaces blood within the vein, allowing the polidocanol to make direct and sustained contact with the vein wall.
- Polidocanol disrupts the endothelial cells that line the inside of the vein, causing irritation and inflammation.
- This cellular damage, known as sclerosis, causes the vein walls to stick together and collapse.
- Over time, the body's natural healing process absorbs the treated vein, which is replaced by fibrous connective tissue.
- The foam is designed to be rapidly dispersed and deactivated upon contact with healthy blood, limiting its effect to the target vein.
The Varithena Procedure: A Step-by-Step Overview
The Varithena procedure is a straightforward, in-office treatment that typically takes less than an hour. Patients can generally return to most normal activities the same day with minimal downtime.
Here is a general outline of what to expect:
- Preparation: The vein specialist will review the patient's medical history and perform an ultrasound to map the targeted veins. The treatment area will be cleaned and sterilized. Local anesthesia may be used to minimize discomfort during the injection.
- Injection: A small amount of Varithena microfoam is injected into the malfunctioning vein, often through a single needle or a small catheter, under real-time ultrasound guidance. The ultrasound ensures the foam is accurately placed and fills the desired section of the vein.
- Post-Injection: Immediately following the injection, the vein specialist will apply compression bandaging and stockings to the treated leg. The patient is advised to walk for at least 10 minutes while being monitored to encourage healthy blood flow through other vessels.
Who is a Candidate for Varithena?
Varithena is an effective option for many people with symptomatic varicose veins, but it is not suitable for everyone. A vascular specialist will conduct a thorough evaluation to determine eligibility, which may include:
- Individuals with visible varicose veins stemming from incompetence in the GSV system.
- Patients experiencing symptoms such as heaviness, aching, swelling, itching, or throbbing in the legs due to venous insufficiency.
- Those who prefer a minimally invasive alternative to surgery, with minimal downtime and no need for general anesthesia.
Contraindications include a known allergy to polidocanol or a history of acute thromboembolic disease. Patients with reduced mobility, a history of deep vein thrombosis (DVT), or recent major surgery may have an increased risk of thrombosis and require careful consideration by their doctor.
Varithena vs. Other Varicose Vein Treatments
Understanding the differences between Varithena and other popular varicose vein treatments can help in making an informed decision. The following table compares Varithena with thermal ablation (like radiofrequency or laser ablation) and traditional sclerotherapy.
| Feature | Varithena (Polidocanol Foam) | Thermal Ablation (e.g., RFA, EVLA) | Sclerotherapy (Liquid) |
|---|---|---|---|
| Invasiveness | Minimally invasive; single needle stick or catheter. | Minimally invasive; small incision for catheter. | Minimally invasive; multiple injections. |
| Mechanism | Injectable foam displaces blood, irritates endothelium, and collapses vein. | Uses heat (radiofrequency or laser) to cauterize and close the vein. | Injects a liquid sclerosing agent to collapse and seal smaller veins. |
| Vein Suitability | Versatile; effective for a wide range of vein sizes, including large, deep, or twisted veins. | Primarily for larger, straight truncal veins. | Best for small varicose veins and spider veins. |
| Anesthesia | No general anesthesia or tumescent anesthesia required. | Requires tumescent anesthesia and local anesthesia. | Often uses minimal to no local anesthesia. |
| Recovery | Quick; minimal downtime, return to light activity same day. | Quick; minimal downtime, may have slightly longer recovery. | Quick; minimal to no downtime. |
| Complications | Avoids risk of heat-related nerve or skin damage. Risk of venous thrombosis. | Risk of nerve or skin injury from heat. Risk of DVT. | Fewer serious complications; focuses on surface veins. |
| Insurance Coverage | Often covered if medically necessary. | Often covered if medically necessary. | Less likely to be covered unless medically necessary. |
Potential Side Effects and Safety Profile
While Varithena is generally well-tolerated, it is essential to be aware of potential side effects and safety considerations.
Common side effects include:
- Leg pain or discomfort
- Injection site bruising, hematoma, or pain
- Skin discoloration
- Injection site warmth or irritation
Serious, though rare, risks include:
- Anaphylaxis: Severe allergic reactions have been reported with liquid polidocanol. Patients are observed for at least 10 minutes post-injection.
- Venous Thrombosis: While uncommon, Varithena can cause blood clots, including deep vein thrombosis (DVT). Neurological events like migraines have also been reported, particularly with earlier foam formulations.
- Tissue Ischemia and Necrosis: Accidental injection into an artery can lead to severe tissue damage.
Careful patient selection and adherence to proper administration techniques are critical for a safe procedure.
Benefits of Choosing Varithena
Varithena offers several significant advantages for both patients and healthcare providers:
- Non-Surgical: The procedure requires only a single injection site and no incisions, leading to a much less invasive experience than vein stripping.
- Versatility: The microfoam can treat a wide range of vein types, including deep, large, and highly twisted vessels that are often challenging for other methods.
- Improved Symptoms and Appearance: In clinical trials, Varithena has been proven effective at reducing symptoms such as aching, heaviness, and swelling, while also improving the aesthetic look of the treated leg.
- Minimal Downtime: Patients can quickly resume their daily routines with minimal recovery time.
- Reduced Risk of Nerve Injury: Because it is a non-thermal procedure, Varithena eliminates the risk of heat-related nerve or skin damage associated with thermal ablation.
Recovery and Aftercare
Following a Varithena procedure, a swift recovery is typical with a few key aftercare instructions to ensure the best outcome:
- Compression Therapy: Patients must wear compression stockings for approximately two weeks following treatment to aid healing and support blood flow to healthy veins.
- Activity: Light activities and walking are encouraged from the day of the procedure. However, strenuous exercise, long periods of inactivity, and hot baths should be avoided for about a week.
- Follow-Up: A vein specialist may schedule a follow-up ultrasound to confirm the vein has collapsed and check for any potential complications. Additional treatment sessions may be needed in some cases.
Conclusion
What is Varithena? It is a state-of-the-art, minimally invasive medical treatment offering a highly effective alternative to surgery for symptomatic varicose veins. Its patented polidocanol microfoam works by damaging and collapsing the inner lining of diseased veins, thereby improving symptoms and appearance with minimal patient downtime. By utilizing ultrasound guidance and avoiding heat, it provides a precise and safe treatment option, particularly for larger and more complex veins. As with any medical procedure, proper patient selection and adherence to aftercare instructions are crucial for successful results. For individuals seeking a less invasive path to healthier, more comfortable legs, Varithena represents a significant advancement in vascular medicine. Find more information about Varithena and varicose vein treatments at your doctor's office or on the official Varithena website.
