Laser treatment for varicose veins

Treatment Overview

A laser is a highly focused beam of light. A doctor can use a laser to treat varicose veins. Laser heat damages a vein, which makes scar tissue form. This scar tissue closes the vein. A closed vein loses its source of blood and dies. After a year or two, the vein is likely to disappear.

Simple laser treatment. Until recently, laser vein treatment has been limited to spider veins and tiny varicose veins just under the skin's surface. Usually, more than one laser session is needed. They are scheduled every 6 to 12 weeks, as prescribed by your doctor. (If you have poor blood circulation feeding these tiny veins, the larger "feeder" vein must first be treated with surgery, endovenous laser or radiofrequency treatment, or sclerotherapy.)

Endovenous laser treatment. This newer technology is becoming more available for larger varicose veins in the legs. A laser fiber is passed through a thin tube (catheter) into the vein. While doing this, the doctor watches the vein on a duplex ultrasound screen. Laser is less painful than vein ligation and stripping surgery, and it has a shorter recovery time.¹ Only local anesthesia or a light sedative is needed for laser treatment. (For vein surgery, general anesthesia is used to put you to sleep.) Studies show that endovenous laser is very effective.¹

What To Expect After Treatment

You are likely to be able to return to your normal daily routine after simple laser treatment.

After endovenous laser treatment, you will wear compression stockings for 1 week or more. To follow up, your doctor will use duplex ultrasound to make sure that the vein is closed.

Why It Is Done

Simple laser treatment is done for small spider veins and tiny varicose veins. This is sometimes a second treatment step, after a larger varicose vein has been treated with surgery, endovenous laser or radiofrequency treatment, or sclerotherapy.

Endovenous laser treatment is used to close off a larger varicose vein, instead of using surgery to remove it.

How Well It Works

Simple laser treatment. Over the past twenty years, this type of laser treatment has become quite safe and effective.²

Endovenous laser treatment. Studies show that endovenous laser closes veins up to 98% of the time, with less pain and shorter recovery time than vein ligation and stripping surgery.¹ Treatment success after several years has not been studied.

If endovenous laser treatment does not close a vein, you will need a second treatment. Depending on what is available in your area, you may have choices between another laser treatment, radiofrequency treatment, or sclerotherapy. In some cases, vein surgery is recommended.

For the best chance of success, be sure to have a doctor with a lot of endovenous laser experience.

Risks

Side effects of laser treatment include:²

• Skin burns.
• Skin coloring changes.
• Feelings of burning, pain, or prickling after recovery, from nerve damage (less likely than after vein stripping surgery).
• Small or large blood clotting in the vein or a deep vein (less likely than after vein stripping surgery).

The more experience your doctor has had with laser, the less risk you are likely to have. Talk to your doctor about how often these side effects happen in his or her practice.

What To Think About

Compared to vein stripping and ligation surgery, endovenous laser and radiofrequency treatments usually cause less pain and have a shorter recovery time.² This is because these treatments are done through a small incision. A larger groin incision is not needed. Plus, these treatments do not require general or spinal anesthesia.¹

If you are thinking of laser treatment, consider some questions to ask about varicose vein treatment. These questions include: How much experience does the doctor have with the particular treatment? How much do the exam and treatment cost? How many treatments does the doctor think you will need?

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

Citations

1. Teruya TH, Ballard JL (2004). New approaches for the treatment of varicose veins. Surgical Clinics of North America, 84(5): 1397-1417.

2. Bartholomew JR, et al. (2005). Varicose veins: Newer, better treatments available. Cleveland Clinic Journal of Medicine, 72(4): 312-328.

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