Varicose Vein Treatment in Orange County


At The Vascular & Endovascular Institute of Orange County, we are able to offer a variety of treatments for comprehensive management of vein disease. Dr. Nishanian treats patients with varicose veins, venous reflux, spider veins, and venous insufficiency. These conditions are common and afflict adults of all ages. In the United States, an estimated 20-25 million people suffer from these vein conditions. The majority of patients are women, while men often present at a more advanced stage. Varicose veins are known for their blue color and bulging appearance under the skin. Spider veins appear as distinctive purple or pink streaks in the skin. These vein conditions are treated with minimally invasive office treatments – thermal vein ablation (such as the VNUS Closure® procedure), sclerotherapy, or occasionally with open surgery for cases of more advanced vein disease. Contact Dr. Nishanian’s Orange County offices for more information on varicose veins, venous reflux, spider veins, and venous insufficiency , or to make an appointment.

About Venous Disease: Understanding Superficial Venous Reflux

Your legs have a network of veins that return blood from the legs back to the heart. Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux and venous insufficiency develop when the valves lose their seal, causing blood to pool in your legs. Reflux is the condition in which the leaky valves and gravity cause blood to flow backward and pool in your legs and feet

This condition can lead to symptoms of pain or swelling, swollen limbs, leg heaviness and fatigue, varicose veins, spider veins, bleeding from veins, vein inflammation called phlebitis, vein blood clots (called deep or superficial vein thrombosis - DVT and SVT), discolored skin, and skin changes such as thickened skin and skin ulcers. The veins that most frequently cause these problems are the superficial veins of the legs.

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The Closure® procedure

The Closure® procedure is a treatment for patients with a condition known as superficial venous reflux, which frequently is the cause for varicose veins and other painful symptoms.

The VNUS® Closure procedure is a newer and less invasive endovenous treatment performed in Dr. Nishanian’s Orange County offices. A treatment fiber called a catheter is inserted in the diseased vein to deliver a heat energy treatment. The treated vein shrinks and over time disappears. The procedure is called endovenous thermal ablation, and is an alternative treatment option to traditional vein stripping surgery.

The Closure procedure is performed on an outpatient basis. Using ultrasound, Dr. Nishanian will position the Closure catheter into the diseased vein through a needle puncture. The catheter delivers heat energy to the vein generated by radiofrequency (RF). After the RF energy is delivered to the vein wall, the catheter is withdrawn. The heat causes the collagen in the wall to shrink and the vein to close. After the diseased vein is closed the backward flow of blood is eliminated, and blood flow is re-routed to the nearby healthy veins.

Following the procedure, a compression stocking is placed over the insertion site to aid proper healing. You are encouraged to walk, and may be advised to refrain from prolonged standing and strenuous activities for several days. Patients who undergo the Closure procedure typically resume normal activities within a day.


Highlights of the Closure® procedure

  • Relief of symptoms
  • Resume normal activity within one day
  • Outpatient procedure
  • Local anesthesia
  • Good cosmetic outcome with minimal to no incisions, scarring, bruising or swelling


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