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November 12, 2018

Ditching Vein Pain

By SharingMayoClinic

For years, leg discomfort from varicose veins made it tough for Cindy Stone to stay active. But minimally invasive treatment at Mayo Clinic solved the problem and put Cindy back on her feet.

For years, leg discomfort from varicose veins made it tough for Cindy Stone to stay active. But minimally invasive treatment at Mayo Clinic solved the problem and put Cindy back on her feet.


Cindy Stone loved to be active — whether it was going for a walk, working in her garden or spending time with her grandchildren. But a dull ache in her right leg due to varicose veins began to cramp her style.

"It wasn't anything terribly bothersome, but you knew it was there, especially if I was doing some gardening or doing a lot of walking outside," says Cindy, a 70-year-old Chetek, Wisconsin, resident. "I'd kind of sit and rub it, and I'd feel a little bit better. But it was getting progressively worse the older I got."

Going for a daily walk went from something Cindy welcomed to something she shied away from, knowing she'd pay the price with a throbbing leg later.

Then the varicose veins began to bulge on her leg, "and they look so ugly — like a pencil sticking out of there," says Cindy, remembering how she didn't want to wear shorts or skirts because she was self-conscious about the veins.

Seeking relief

After coping with the discomfort for about seven years, Cindy decided enough was enough. She brought up the issue during her annual exam with Rebecca Sarauer, a physician assistant at Mayo Clinic Health System — Northland in Chetek. She advised Cindy that some varicose vein sufferers can get by with wearing compression stockings. While doing so doesn't cure the problem, it can help ease the pain. She also recommended Cindy schedule an evaluation with Timothy Berkseth, M.D., a surgeon at Mayo Clinic Health System — Northland in Barron, Wisconsin, who has expertise in minimally invasive varicose vein treatments.

Cindy had her reservations, but she heeded the advice.

"For most people, especially as you get a little older, you're not real anxious to go see a surgeon," she says. "You just kind of put it off, and you think, 'Oh, I don't know if I want to go through all of that.' But I have to tell you, this doctor had such a bedside manner. It was just phenomenal. He explained everything, and I just had absolutely no questions left unanswered about the whole process."


"We have a lot of good minimally invasive options now for the treatment of chronic vein disease."

Timothy Berkseth, M.D. 

Dr. Berkseth explained to Cindy that she had chronic vein disease. The achy, heavy feeling in her leg was occurring because blood wasn't flowing upward in the vein properly.

"The veins in our legs have one-way valves in them that are supposed to prevent blood from going back down the leg," Dr. Berkseth says. "Over time, the little valves can get leaky from chronic vein disease. With that, instead of flowing up the leg, your blood starts to flow back through these leaky valves. You get extra blood volume in those veins, and you see the bulges — the varicose veins — and then have pain, achiness, heaviness and swelling."

In April, Dr. Berkseth performed two minimally invasive outpatient procedures on Cindy's right leg. The first procedure is known as endovenous radiofrequency ablation. Dr. Berkseth threaded a long catheter through the greater saphenous vein, a vein near the surface of Cindy's leg that was affected by chronic vein disease. He then delivered radiofrequency energy to the end of the catheter and treated the vein one segment at a time — heating the inside of the vein to 248 degrees F — causing permanent injury to the vein's inner lining.

"Although we're not physically removing the vein like we used to do with vein stripping, the minimally invasive procedure renders the vein completely useless because it scars down such that blood can no longer flow through it," Dr. Berkseth says. "Basically, you don't have blood flowing through the bad veins, and it then gets redirected into the deep veins that are functioning well."

The second procedure — stab avulsion phlebectomy — involved treating other visible varicose veins that were likely side branches off Cindy's diseased vein.

"We make a tiny incision over each varicose vein and physically remove short segments of these veins that look abnormal," Dr. Berkseth says. Just like the first procedure, blood is rerouted to healthy veins so circulation is not affected.

Loving the results

Cindy marvels at how much better she feels today, and she wonders why she waited so long to be evaluated.

"I'm so glad I did this, and, really, I would encourage anyone — even if you've just started with some of this dull aching — not to wait," Cindy says. "It's just so nice to have that gone and taken care of."

Dr. Berkseth says that's a common response once the condition has been treated.


"I'm so glad I did this, and, really, I would encourage anyone — even if you've just started with some of this dull aching — not to wait."

Cindy Stone

"We have a lot of good options now for the treatment of chronic vein disease with these minimally invasive procedures," he says. "Most patients do well and are happy with the results. The complication rate of surgery is low, so it has a good risk-benefit reward."

Cindy says she can't praise Dr. Berkseth enough for a job well-done.

"He and his staff are just phenomenal," she says. "For them, I'm sure it's routine. Surgery and taking care of these things for people is their job. But in their hands, I just felt like a part of the whole thing and felt so comfortable."

Note: A version of this story was published previously in Hometown Health.


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Tags: Dr. Timothy Berkseth, Endovenous radiofrequency ablation, Mayo Clinic Health System, Rebecca Sarauer, Varicose veins

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