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Laser Surgery for Varicose Veins
2007-02-22
Dear Dr. Proskiw:
I have been waiting for varicose vein surgery for over a year and a half. I’m 42 years old, fit, physically active, and have 2 teen aged boys who are busy in hockey and baseball. My legs ache when I sit or stand for prolonged periods and I’ve developed leg cramps and restless legs at night. My husband is tired of my complaining and tells me I should have laser surgery for my varicose veins. He has a buddy at work that had Varicose Vein Laser Surgery one day and was back at work the following day. Can you tell me something about this procedure?
Answer:
You are referring to Endovenous Laser Vein Surgery. This is a relatively new procedure developed by a radiologist in New York several years ago. It is extremely effective for most patients and was developed for patients who did not want to take time off from their busy schedules, did not want to have vein stripping, or were surgical risks because of their general health. It is interesting to note that new studies have shown this procedure to be 98% effective compared to surgical stripping which is about 85% effective in treating this progressive and debilitating disease. The procedure of course first involves a medical assessment, with ultrasound mapping, to determine the origin of your varicose veins. Most people with visible varicose veins and symptoms have a leaking valve(s) in the upper thigh or groin making it imperative to have an ultrasound exam that actually gives a picture of venous anatomy and the origin of the problem. A laser fiber is threaded through the vein up to the problem area and when the laser is activated it closes the vein as the fiber is withdrawn. This is done under local anesthesia comparable to a dental procedure. The laser fiber is inserted through a small needle so there is no need for stitches in most cases. When the puncture wound heals in 7 – 10 days it is virtually invisible. The patient must walk immediately after the procedure and resume normal walking the following day. Compression stockings are usually worn for 5 -7 days following the procedure.
Question:
You make this procedure sound simple. Are there any risks or age limitations for this procedure?
Answer:
It is not simple to perform but the medical principle of laser treatment is sound and proven. Lasers allow precise treatment of tissue by heating specific targets. In the case of varicose veins, the laser light targets blood and water within the vein, thereby heating the inside wall of the vein, causing it to shrink and close. Laser hair removal on the other hand targets the pigment melanin, in the hair follicle, and destroys the follicle selectively without damaging the surrounding skin.
Endovenous Laser Vein Surgery is very safe but does require that the patient be mobile and active. Because it is performed under local anesthesia it is safer than a general anesthetic and there is obviously less scarring than vein stripping. I have not seen or read of any incidences of deep vein blood clots and have performed the procedure on patients aged 23 to 84 years of age without any major problems. The procedure is also indicated for the older patient with multiple health issues who is a higher general anesthetic risk.
I would suggest that you see your primary care physician for a referral to a physician specializing in vein disease and have compression stockings prescribed for your legs. This may give you temporary relief of your symptoms until you have something definitive done for your varicose veins.
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