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Longview surgeon uses high-tech treatment for varicose veins

By by Sarah Thomas
March 21, 2012 at 10 p.m.

A Longview physician is helping take correcting severe varicose veins from the "gruesome" procedure of stripping the veins to a simplified approach commonly referred to as "lunch-break surgery."

Dr. Randy Morton is one of the doctors who performs the FDA-cleared catheter procedure that uses a radiofrequency technique sometimes called the "microwave on a stick."

Endovenous Radiofrequency Ablation for Venus Reflux Disease is used to correct spider veins, severe varicose veins, stasis dermatitis and stasis ulcers.

This minimally invasive method heats and seals the primary leg vein in minutes, leaving most patients able to return to normal activities the next day, Morton said.

"I trained to do vascular surgery in the 1980s," he said. "No one wanted to do vein surgery because it's not glamorous, but I piddled around in it, and it became something that really helps people and makes them happy."

Today, Morton treats about four to five patients a week using the catheter closure procedure.

"This came out in around 1999. We've been doing it since about 2000 or so," he said. "A dermatologist friend of mine told me about it, so I figured I'd check it out."

Severe varicose veins, which affect about 30 million Americans, can cause leg heaviness, aching or cramping, leg or ankle swelling, burning or itching of the skin, restless leg, skin changes and lower-leg ulcers. In extreme cases, it also can lead to amputation.

"You'll see these people walking around with purple ankles, and most people can get by with it for a long time," Morton said. "But once it gets bad, it gets really bad."

He said most doctors aren't aware of the newer catheter procedure.

"In the old days, all you could do is vein stripping where you would be out for weeks. This is a kinder, gentler procedure," Morton said. "When I trained, (the procedure) wasn't invented. I had to learn it on the fly."

Since the procedure addresses a serious medical condition and is not considered cosmetic, it is covered by Medicare, health insurance, the TRICARE military health plan and the Veterans Administration.

Selena Priddy of Longview had the procedure on her left leg three weeks ago, and Wednesday morning she was back in Morton's office for her right leg.

"It turned out really well. Everybody here is really nice," Priddy said. "I'm looking forward to getting this other one done."

Priddy has suffered with varicose veins for at least 30 years and said she already notices a difference in the appearance of her left leg.

"It's still a little sore in some places, but it looks a lot better," she said. "It's not as swollen and poofed out as before."

Priddy said she decided to have the surgery because Morton said the condition would worsen and could lead to a wound that wouldn't heal.

Priddy's surgery took less than an hour to complete, and she was able to talk to the doctor as he was performing the surgery. Once Morton finished prepping the vein for the catheter and applying local anesthesia, the catheter was inserted into the vein up to the groin.

The catheter is gradually pulled down, heating the vein in 7-centimeter sections for 20 seconds. Morton said this ensures the vein in evenly treated. Priddy's vein was heated and sealed three minutes and 20 seconds later.

Priddy was left with one small hole and minimum discomfort.

"One thing that has really helped us do this is a less costly ultrasound with a great screen resolution," Morton said. "Before, we did this blindly. We'd insert this plastic thing kind of like a weed eater, go all the way up the the groin and pull the thing out.

"With this procedure, the patient will have a pulling sensation almost like pulling a cord, but they won't have any pain."

As with all medical procedures, Morton said risks were involved, including blood clots in the deep system, known as Deep Vein Thrombosis (DVT) and superficial venous phlebitis or sore spots.

Morton said the sore spots can be treated with a topical anti-inflammatory cream.



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