Dr. Jeffrey Morris Apple, who is board certified in general and vascular surgery, added the specialty of vascular surgery to Jackson Surgical Associates when he joined the clinic in July 2007. Vascular surgeons are trained in the diagnosis and medical and surgical treatment of peripheral vascular problems, which include the blood vessels of the arms, legs, neck and abdomen.

Dr. Apple is the first surgeon in Jackson to offer thoracic aortic stent grafting for thoracic aneurysms.

Dr. Apple is from Dallas, Texas. He received his undergraduate degree from Texas A&M University. After completing medical school at the University of Texas HSC in San Antonio, he went on to residency at UT Southwestern/Parkland Memorial Hospital in Dallas. Before completing his fellowship in vascular surgery at Baylor University Medical Center in Dallas, he served four years in the U.S. Navy as a staff general surgeon at the Naval Medical Center San Diego. During that time, he was deployed twice to the Persian Gulf in support of Operation Iraqi Freedom. He is a Fellow of the American College of Surgeons and an active member in the Society of Vascular Surgery, Parkland Surgical Society and Alpha Omega Alpha.

Dr. Apple and his wife, Trudy, have two children. He enjoys traveling, fly fishing, scuba diving and history.

New office procedure treats varicose veins

Varicose veins – often painful and unsightly – affect about 25 million people in the United States.

A new office procedure at Jackson Surgical Associates treats the severe cases of varicose veins in most people without the patient needing the traditional surgery of vein stripping, says Dr. Jeffrey Apple, a board-certified general surgeon. He has completed a fellowship in vascular surgery. It is estimated that 72 percent of American women and 42 percent of the men will experience varicose veins by the time they are 60.

A leading cause of varicose veins, also called venous reflux disease, is incompetent or leaky valves in the saphenous vein that runs from the ankle to the groin in each leg, explained Dr. Apple.

The job for veins in our body is to carry blood back to the heart. Valves in the saphenous vein open when muscles contract to push the blood back to the heart and then close to prevent the blood from flowing backwards. “Incompetent or leaky valves allow some of the blood to flow backwards and pool up or collect in the lower legs,” Dr. Apple says.

Common risk factors that lead to varicose veins are a history of blood clots, obesity, multiple pregnancies and jobs that require a lot of standing. In many people, varicose veins appear as bumps in the leg, or large painful, bulging veins. In some people, though, the incompetent vein is hidden in the leg, but still causing symptoms.

“The most common complaints are swelling, pain and discomfort from being on your feet,” says Dr. Apple. “It’s amazing how uncomfortable people are.”

Left untreated, the condition can worsen. Some patients develop large ulcers or open sores on the ankles. Some patients develop blood clots. Legs swell and are tender. In some patients, the symptoms are so severe that the patient cannot function or go to work.

Treatment for varicose veins is based on the severity of the symptoms, says Dr. Apple. The first step includes a thorough medical history and physical examination. Ultrasound is then used to evaluate both the deep and superficial veins to see if they are incompetent or if other problems are causing the symptoms, he adds. He also treats any ulcers or other complications before tackling the varicose veins.

If the varicose symptoms are not severe, Dr. Apple first suggests that the patient keep his or her legs elevated when they are resting and to wear compression hose, which are stockings prescribed by the doctor that fit snugly and relieve the swelling. “It gets gravity on the patient’s side.”

If the compression hose do not relieve the symptoms, an office-based procedure, called ClosureFast offers a good option. The procedure uses radio-frequency energy to close off the incompetent vein so blood cannot go into it. The body eventually reabsorbs the bad vein, and blood is rerouted to other healthy veins.

The procedure requires a mild sedative and local anesthetic, Dr. Apple says. He treats one leg at a time with each leg taking 30 minutes to an hour. He closes the small incision with skin glue. Most insurance companies cover the procedure.

For certain patients, though, traditional surgery is the best option. The surgeon makes tiny incisions in the legs and literally removes the bad vein.

The office-based ClosureFast procedure, offered at Jackson Surgical, is replacing the traditional surgery in most instances, Dr. Apple says. “Patients are awake and talking to us during the procedure. They can walk out of the office and be back to work the next day.”