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Cutting-edge method to treat varicose veins

Shinichi Okamoto, the director of the Akabane Varicose Veins Clinic in Akabane, Kita Ward, Tokyo, had only a vague inkling of a career that could make the best use of his manual dexterity when he was a boy growing up in Kyoto.

News photoShinichi Okamoto, the director of the Akabane Varicose Veins Clinic in Akabane, Kita Ward, Tokyo, poses at his clinic on April 20. YOSHIAKI MIURA

Becoming a surgeon was the path he ultimately chose. After working at a university hospital for 10 years, he received his M.D. and moved from Kyoto to Tokyo. After working in a clinic specializing in vascular surgery in Shinjuku for two years, he decided to open his own clinic to focus on varicose veins.

"There are not enough doctors compared to the numbers of the patients suffering from varicose veins and I felt I should be the one," Okamoto said.

Varicose veins are gnarled, enlarged veins. Although any vein may become varicose, the veins most commonly affected are those in people's legs and feet. The most common varicose veins are spider veins. It is a mild variation of varicose veins, and is simply a cosmetic concern. But other symptoms such as cramps or swelling cause discomfort, while even more severe symptoms such as aching and bleeding can occur.

Generally, blood travels from a person's feet to their heart, with valves within the veins preventing the backward flow of blood. However, when these valves get defective or are damaged, blood clogs within the veins in the lower legs, forming lumps. Heredity; pregnancy and childbirth; extended periods of standing and walking upright; and aging are considered to be the four main factors behind the valves working less efficiently.

Varicose veins are common, with one in 10 women and one in 13 men over the age of 40 suffer from the condition in Japan. However, because varicose veins are not deadly, not many doctors devote themselves to treating the disease. According to Okamoto, there are many instances that see patients visiting large hospitals hoping to have their varicose veins treated, only to be sent home without receiving satisfactory treatment.

"In the world of vascular surgery, the most prioritized area is the heart, followed by arteries and lastly veins. Naturally, doctors take diseases with higher fatality rates more seriously, so unfortunately varicose veins remains a disease not taken seriously."

Okamoto chose Akabane to open his clinic because of the easy accessibility from both Tokyo and Saitama Prefecture. Akabane Varicose Veins Clinic opened in February 2015.

The clinic offers various treatments depending on the severity of the conditions. For the mildest cases, wearing compression socks is usually recommended. For the cases where the varicose veins are spider veins, yet the valves within the veins are not defective or damaged, sclerotherapy would be applied. It involves injecting a chemical inside the vein that destroys it and causes it to scar. It only takes about 10 minutes to undergo this treatment.

For the cases that the valves within the veins are defective, radiofrequency ablation therapy would be applied. It is a newer technique that is largely replacing stripping; a mainstream method that saw a "tunnel" placed between two points under the skin, and dragging or pulling the saphenous vein out of the tunnel.

Radiofrequency ablation therapy uses high-frequency energy to destroy the vein. A probe is placed in the vein using ultrasound and once in position, the varicose vein is heated along the entire length. The procedure usually takes 20 to 30 minutes, and there is minimal bleeding and bruising, resulting in less pain and a faster return to regular activities. Unlike the stripping, which required hospitalization, radiofrequency ablation therapy is an outpatient procedure. Akabane Varicose Veins Clinic offers all these treatments, which are covered by national health insurance.

"My most important task is finding out what exactly each patient wants from treatment through counseling and offering the best method. Even if what the patient wants is not what I'd recommend as a doctor, I try to respect patient's choices and support them," Okamoto said.

Because it is not a fatal disease, patients have more options on whether or not to treat the condition. There can be a 90-year-old female patient who wants to get rid of spider veins on her legs, while a male patient in his 60's may not care about removing bloody lumps on his legs as it is just a cosmetic concern. In each and every case, Okamoto offers accurate information so that the patients can make the best decisions.

Okamoto hopes more patients will find out how much better they will feel by having their varicose veins treated, allowing them to go about their lives with healthy legs.

This series has been prepared in collaboration with Enjin Co., which produces and operates a video website, kenja.tv, specializing in profiles of up-and-coming Japanese entrepreneurs.