AUGUSTA — A local doctor is pioneering an innovative type of vein surgery he calls a “lunchtime procedure” that can be completed in an hour with the patient ready to leave soon thereafter.

A recent patient was MaineGeneral Medical Center operating room nurse Vickie Hunnewell, who developed varicose veins in her legs after years of standing on her feet for long hours, assisting surgeons.

Those are enlarged veins filled with an abnormal collection of blood that often look like cords and may appear twisted or bulging.

Hunnewell, 46, of Gardiner, learned that MaineGeneral’s vascular and thoracic surgeon, Dr. Cris Alvarado, was performing Venefit procedures, which involve much less recuperation time than other varicose vein surgeries.

She decided it was time to take action.

“My legs are tired and I’ve been experiencing a lot of discomfort,” Hunnewell said. “So I decided to do something about it.”

Alvarado, a 46-year-old former heart and lung transplant surgeon, practiced in Florida, then was in private practice in Delaware before moving to Readfield. He became interested in the Venefit procedure as a junior attending surgeon. He said a classmate of his from college, Dr. Robert J. Min, who is now president of the American College of Phlebology, invented the procedure.

“We call it a ‘lunchtime procedure’ because many patients are able to have it during their lunch break,” Alvarado said.

Alvarado said one of his former chief residents when he trained at New York University, Dr. Mark Adelman, coined the term “lunchtime procedure” during in an interview with Diane Sawyer on Good Morning America in 2009.

Alvarado estimated that he’s performed hundreds of Venefit procedures since 2004.

“Previously, I had performed the procedure at MaineGeneral in Augusta, in both the operating room, in the minor procedure room and in my office in the hospital,” Alvarado said. “Prior to moving to Maine, I had performed the procedure in my office as a private-practice physician in Delaware.

Alvarado said he spends a lot of time performing “more serious vascular and thoracic procedures such as for lung or esophageal cancer, so this procedure, which can be done in an outpatient setting, is a nice break from those.”

Alvarado performs the Venefit procedure at the Manchester Medical building, using local anesthesia, which is a numbing agent injected beneath the skin. He said some other varicose vein procedures that are more invasive, such as vein stripping, may require up to four weeks recuperation after veins are tied off and removed from the leg.

One of the most common risks of the Venefit is bruising, which occurs in up to 10 percent of people having the procedure; and a less frequent risk is blood clotting, Alvarado said. He added that both of those are risks with other varicose vein procedures as well.

Alvarado performed Hunnewell’s procedure at the Manchester Medical building, using local anesthesia, with the assistance of another MaineGeneral operating room nurse, Kim Gallant.

He said the recuperation time is much shorter than for other procedures such as vein stripping, which may require up to four weeks of recuperation after veins are tied off and removed from the leg.

One of the most common risks is bruising, which occurs in up to 10 percent of people having the procedure, Alvarado said, and a less frequent risk is blood clotting. Both of those are risks of other varicose vein procedures as well, he said.

He performs the Venefit procedure using ultrasound to show images inside the vein, while threading a catheter through it. A small probe is then inserted through the catheter and a device inside the probe heats up inside the vein, closing it off. The procedure can be performed using only local anesthesia.

After the damaged veins are sealed off, Alvarado said, healthy veins in the area should pick up the normal blood flow. He said the damaged veins should then shrink and symptoms should improve.

Nurse Hunnewell’s recent procedure lasted about an hour. She walked out of Manchester Medical Building with her leg bandaged in an ace wrap.

Alvarado encourages patients to be active after the surgery to promote circulation to the legs and to help prevent complications.

“I stress to patients that there is no requirement to take time off from work following the procedure or think there will be any required down time,” he said. ” … We encourage and instruct patients to be as active as possible after the procedure.”

According to Alvarado, the average cost of a Venefit procedure is about $500 and it’s covered by many insurances because “they recognize that reimbursing for a procedure early in the disease course cuts way down on costs incurred from managing and treating advanced disease.”


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