By Richard A. Baum, MD, MPA, MBA
Until recent years, treatment for painful and often unsightly varicose veins was itself painful and required extended time for recovery.
Varicose veins develop when the larger veins beneath them stop working. When this occurs, blood pools in the smaller veins causing them to bulge and take on a ropelike appearance. Weight change, pregnancy and aging can contribute to the development of varicose veins.
Traditional surgery for varicose veins, commonly called wire stripping, involves removing the main vein of the leg called the greater saphenous vein. The surgery — the only treatment option for many years — was invasive, painful, caused scarring and required weeks for recovery.
Other procedures, such as ultrasound-guided sclerotherapy (which involves injection of an irritant into the vein causing it to close) and radio frequency closure (which delivers radio frequency to shrink and seal the vein) had been developed over the past couple of decades — but these procedures were more effective on smaller healthier veins and not as successful with the larger defective vessels that result in varicose veins.
Several years ago, treatment for these defective veins was turned upside down when a revolutionary new technique called Endovenous Laser Treatment (EVLT®) was developed. Proven to be highly effective and safe since its introduction, the EVLT® technique involves administration of a local anesthesia, insertion of a thin laser through the greater saphenous vein ultrasound imaging to locate the area of the vein that is not working. Once the defective vein is located, the doctor then guides the laser to the problem area and proceeds to close off the vein that is not working, allowing smaller, healthier blood vessels to take over the task of circulating blood in that area.
Patients who undergo the procedure can resume normal daily activities the next day, wear support stockings for about a week and can resume strenuous exercise in two weeks. Not only can EVLT® be performed in an office setting in a short period of time — between 20 minutes and one hour — it eliminates the risks associated with anesthesia and surgery and avoids the scarring associated with traditional varicose vein treatments.
While EVLT® is suitable for most patients with varicose veins, it is important to discuss your individual vein health and possible treatments with your doctor.
