Reno physician pioneers varicose vein treatment

In his own words, Reno vascular surgeon Dr.

Robert Merchant Jr.

was "very, very skeptical" when he first heard of medical technology to replace the stripping technique used in the treatment of varicose veins.

Just over five years later, he's so sufficiently sold that he's become an advisor to the maker of the technology, and he recently was on the road spreading the word in China.

"This treatment really makes a difference in the way that medical care can be used to improve a patient's problem and do it safely,"Merchant said a few days ago.

In a medical career of more than 25 years, Merchant had done his share of vein stripping.

In that procedure, a surgeon makes an incision in the patient's groin, ties it off, then removes the vein through a second incision just above the calf.

Although that procedure, common for nearly 100 years, usually is done as outpatient surgery these days, it still can require several weeks of recuperation before the patient can return to work.

A procedure commercialized in the late 1990s by VNUS Medical Technologies Inc.

of San Jose, however, uses radiofrequency waves to close off a vein.

A catheter,Merchant explains, is inserted into the vein through a tiny opening.

The catheter delivers radiofrequency waves that cause the vein to heat, collapse and close off.

The system was introduced in Europe in 1998 and cleared for marketing in the United States a year later.

Although skeptical,Merchant was the first physician west of Chicago to try the technology.

After using it with about a dozen patients, he was so convinced that he essentially abandoned the stripping technique.

The procedure, he says, takes about an hour at his Reno Vein Clinic.

Patients are under local anesthetic and provided with a mild sedative.Many patients,Merchant said, can resume normal activities within a few hours after the procedure.

In the earliest days of the technology, before insurance companies routinely paid for the procedure,Merchant sometimes provided it to patients for little more than the cost of materials.

Today, he believes so strongly in the technology that VNUS sends him on the road to demonstrate and discuss its uses.

A few weeks ago,Merchant returned from a four-day presentation to members of the Chinese Vascular Society who met at Shen Yang in Lianing Province.

The Reno physician operated on two patients at People's Hospital in Shen Yang, demonstrating the technique of radiofrequency, and spoke through an interpreter with his Chinese peers.

The Chinese hospital,Merchant said,was reminiscent of American facilities in the 1940s.

But he said Chinese physicians were keenly interested in learning about the uses of new technology.