Varicose vein treatment has advanced from surgery requiring months of recovery to an outpatient procedure performed in about 30 minutes, leaving only a small incision covered with a bandage.

Dr. Brandon Repko, medical director of nuclear imaging and therapeutic services at Butler Health System, said the treatment was recently approved by the American Medical Society and Medicare, and he is looking forward to using it.

He described it as a paradigm change in varicose vein treatment.

The treatment relies on the use of a viscous medical glue made from the same ingredients in Super Glue.

“What this is, is Super Glue. We Super Glue the vein shut,” Repko said.

A catheter is inserted in a vein near the foot and extended to the top of the vein in the leg. The glue is pushed through the catheter while it is slowly pulled back out.

“The vein is never going to open again because it is glued shut. No blood gets through,” Repko said.

He said the vein eventually turns into scar tissue around the glue.

A possible problem is a hypersensitivity reaction to the glue, but the reaction would clear up in a week or two, he said.

The glue is pushed through the catheter by a plastic gun-shaped device, which the manufacturer calls the Venaseal. A plunger in the hand-powered gun pushes the glue similar to the way a calking gun pushes calk, he said.

He estimated that he could treat one vein in 20 to 25 minutes and the incision from the catheter would be covered with a bandage.

“This is another paradigm change,” Repko said.

The last significant changes in varicose vein treatment came in the late 1990s. Both of those treatments also relied on catheters.

One involved a laser that would “weld” a vein closed while the catheter was pulled out of the leg and the other used heat that “cooked” the vein closed as it was pulled out, he said.

Both were painless, outpatient procedures that were 90 percent effective, he said.

Those procedures also had some downsides. A thermal insulator made of saline and a numbing agent was injected at 20 places on the leg to keep the heat inside the vein and patients had to wear tight fitting compression stockings for two weeks afterward, Repko said.

The laser had to be removed at a certain speed to avoid harming the vein and leg. Repko said the laser was strong enough to burn a hole in a wall if it was held in one spot for 20 minutes.

Those methods were vast improvements over the original treatment that involved making an incision along the entire length of the vein, separating the vein from tissue and other veins using a device he likened to an apple corer, cutting out the damaged part of the vein and then tying it off.

“It got really bloody. It took months to recover in the hospital,” Repko said. “That was the standard of care for 50 years.”

The standard has changed, but the reasons for treating varicose veins have not.

It's not vanity.

Repko said leg veins contain about 10 valves that keep blood flowing to the heart. One or two leaky valves don't create problems, but several bad valves allow carbon dioxide to build in the blood, damage tissue and skin and force blood to the feet, he said.

Untreated cases can result in blood “blowing” out of a damaged vein and the skin, and the resulting loss of blood pressure can cause a person to temporarily lose consciousness, he said.

There are many factors that can cause varicose veins. Among them, Repko said, is people who work jobs requiring them to stand for long periods.

Some of the most common symptoms are swelling of legs and veins, itching, fatigue or weakness in legs, hair loss, pigmentation changes and browning of the skin, dermatitis and slow wound healing.

Repko said the majority of varicose vein patients experience one or several of those symptoms.