Endovenous Laser Treatment for Varicose Veins

Lasers have been used for numerous medical applications throughout the body. Recently, a novel technique utilizing laser energy delivered endovenously (directly inside the vein) has been developed to treat varicose veins. An 810 nm diode laser will be used to deliver the laser energy via a small laser fiber. Endovenous laser treatment is performed under local anesthesia in the doctor's office. There is little to no scarring and a relatively short recovery period after the procedure.

Procedure

At your first visit, the doctor will interview you and take a medical history and examine your legs. Duplex ultrasound imaging (a machine which allows the doctor to visualize the blood vessels and record their size and shape) will be scheduled if necessary. Photographs of the treatment areas will be taken.During the procedure, you will be given special eye goggles to protect your eyes against accidental exposure to laser light. Next, the treatment area will be anesthetized with lidocaine. A sterile laser fiber will be

inserted into the vein and positioned under ultrasound guidance. Laser energy will be delivered to selectively treat the target vein. A compression stocking will be applied and must be worn for at least one week following treatment. You will return to the office within one week and the doctor will examine the treated vein. Doppler and duplex ultrasound evaluation will be done and additional photos may be taken. Repeat endovascular laser treatment using modified parameters may need to be done at the discretion of the doctor.

Risks and Discomforts

Results after EndoVenous Laser Treatment have been excellent. It is important to remember that each patient's results may vary; your symptoms of varicose veins may improve, remain the same, or worsen. The potential side effects are thermal injury (burn) to the overlying skin or intervening tissue, perforation of the vein, breakage of the laser fiber, superficial phlebitis (inflammation of the vein), hyperpigmentation (darkening of the overlying skin), or neovascularization (growth of new veins). DVT, PE, and even death have never been reported with EndoVenous Laser Treatment, however, these things have been

reported with every other treatment of varicose veins (surgery and sclerotherapy) therefore, must be considered a possibility. Problems and side effects that are not know at this time could occur. For most people, needle punctures into the vein do not cause any serious problems. However, they may cause dizziness, minimal bleeding, bruising, discomfort, pain, and rarely infection. Local anesthesia will be used to minimize discomfort. Rarely, people can have an allergy to Lidocaine.

Potential Complications of not Undergoing Treatment

The potential complications of not undergoing treatment are often to merely a worsening of the condition, i.e. an increase in the number of veins or enlargement in the existing veins. In case of large varicose veins, spontaneous superficial phlebitis or bleeding may occur. Patients with varicose veins associated with underlying venous insufficiency may develop ankle swelling and/or skin changes (eczema, hyperpigmentation, ulceration).

Alternative Treatments

Since varicose veins and spider veins are not life threatening. Treatment is not mandatory. Some patients may get adequate symptomatic relief by wearing graduated compression stockings. Alternative treatments for varicose veins include surgical ligation and stripping, ambulatory phlebectomy, ultrasound-guided sclerotherapy, bipolar radiofrequency (heat destruction), or combination of these treatments.

Potential Benefits

The potential benefits of the procedure are reduction in the size or closure of the treated varicose veins and improvement in varicose vein-related symptoms. Results to date, although early, have been very promising with essentially no recurrence and good cosmetic appearance. It is also possible that your condition may remain the same or worsen.

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