The main phases of proper varicose vein treatment often include removing the branch veins via endovenous laser therapy and the second is then followed up by injection sclerotherapy. The first phase of treatment can be performed in under an hour with little to no pain. Recovery time is quick allowing a patient to return to work the very next day.
Recently we had the privilege of attending the American Venous Forum in sunny Palm Springs, CA. This was our first visit to the AVF and we had the opportunity to learn quite a bit. Here are a few key takeaways from what we learned at the conference:
Why Laser Vein Treatment is the Preferred Method. Clinical Trial Compares Treatments.
A recent study conducted by the New England Journal of Medicine collected data from 11 varicose vein centers in the United Kingdom which compared treatments for vein disease - finding endovenous laser therapy to be the best option available today for the treatment of the saphenous vein system (medical not necessarily cosmetic vein treatment).
Will I need these (varicose) veins later on? What if I have had previous vein removal, can you treat more veins?
Many patients ask questions regarding the fact that we are treating veins from their body that upon treatment dissolve into the blood, often worried that they will in some way need them later on. Frequently, a patient will inquire about losing veins that may potentially be needed for something like a heart bypass, or whether (for patients that have had previous vein stripping, etc) they can even remove any more veins.
Vein Stripping vs Modern Varicose Vein Treatments.
Traditionally, the only way to treat your vein disease was done by a surgical procedure known as “vein stripping”. Vein stripping is performed in a hospital setting and takes a few hours to perform. The actual procedure involves making incisions up and down the legs allowing for the insertion of a small wire directly into the varicose vein. The wire is then tied to the vein and pulled, or “stripped”, out of the body. Afterwards, the incisions are stitched up and wrapped. Vein stripping requires general anesthetics, because it is as painful as it sounds, and sends the patient home for the next few weeks to recover. In addition to the somewhat barbaric method, vein stripping has shown a steady success rate of under 50% with recurrence rates high. Moreover, vein stripping, as you can imagine, can often cause more damage than benefit to the patient, as it unnaturally destroys the veins.
Fortunately, modern technology has made significant advancements in proper vein care and today successfully treating your varicose veins has never been easier. One of the most popular methods in properly treating your varicose veins is known as “Endovenous Laser Therapy” or EVLT. EVLT differs drastically from vein stripping as it is typically performed in a clinical setting allowing the patient to return to their normal activities immediately following the procedure. Additionally, EVLT uses a optical fiber laser that is inserted into the veins, by way of a catheter, that essentially heats the veins from the inside gently sealing the veins as the fiber is slowly removed. The varicose vein then dissolves into the blood stream, while blood flow is instantaneously directed to properly function veins in the legs. Furthermore, one drastic difference in performing EVLT over vein stripping is the use of a Doppler Duplex ultrasound.
While doctors who perform vein stripping have to insert the wire into the veins blindly, prodding the vein walls back and forth until the wire is fully inserted, the ultrasound used in EVLT procedure allows the vein specialist to accurately see where the laser is going significantly reducing the pain while also decreasing the required procedure time. This is one of the main reasons why EVLT requires no downtime, only local anesthetics, and takes less than one hour with minimal to no pain (also making EVLT less expensive than vein stripping).
More importantly, the success rates for treatments like EVLT are close to 100% with practically no recurrence down the road. It is also worth noting that while almost 50% of the population above the age of 50 have varicose veins, the success rates using EVLT are the same regardless of your age. Lastly, the complications from EVLT are generally very minor, involving some bruising, and temporary numbness or induration or a sensation of tightness.