Varicose Vein Removal

Many of us have them and, if we do not, many will get them one day: varicose veins. Varicose veins are the term given to veins that have lost their elasticity and ability to return blood to the heart as they normally would. This causes the veins to become engorged and distended with blood. Because of this engorgement, the veins near the surface of the skin bulge outward causing rather unsightly, serpentine ridges and bumps on the skin. The existence of varicose veins is not only a cosmetic problem, but also indicates a potentially serious problem with vascular (blood vessel) health.

 

 

Varicose veins are only one of the various manifestations of venous hypertension, or high blood pressure within the veins. While varicose veins and usually relatively colorless bumps, venous hypertension can lead to reticular veins and telangiectasias which are bright red or dark purple veins that are visible through the skin. In more serious cases, venous insufficiency (ineffective blood flow back to the heart) can lead to serious problems in the extremities such as ulcers (holes!) and infections.

 

In addition to improving the cardiovascular health of the patient as much as possible, varicose vein removal through surgery is the primary treatment for these unsightly blood vessels. Diagnosis and treatment of varicose veins dates back thousands of years and was one of the earliest medical disorders. Some of the traditional surgical procedures are built on those original concepts. For example, vein stripping, the literal pulling of the affected vein from the leg, has been performed for centuries. While some current varicose vein removal techniques are related to that approach, newer technological advantages cause fewer complications and deficits and better long term clinical results.

 

One of the newer procedures for varicose vein removal that has shown promise as both effective and safe is endovenous laser therapy. In the procedure, a laser that delivers a certain wavelength and intensity of light energy is used to heat and ablate the varicose veins. Instead of delivering the laser light energy through the skin, a thin catheter is passed into the vein itself and snaked along its length. This endovascular (inside the vessel) probe is gently guided into the varicose vein and the placement is verified using ultrasound, the same technology that is used to visualize fetuses in the womb. Once the endovascular catheter is in place, laser energy is used to heat the blood and blood vessel wall causing it to instantly coagulate and destroy the varicose vein.

 

This method of varicose vein removal can be performed using a form of local anesthesia called the tumescent technique which involves infusing the area to be treated with a large amount of sterile saline (salt water), local anesthetic, and a drug to reduce bleeding. After the varicose vein removal, regardless of the technique, a compression stocking is important for proper healing and the best long term outcomes.

 

Endovenous laser ablation (EVLA) has a successful initial closure rate of 95 to 100 percent and veins stay closed over 90 percent of the time. Given the speed and success of this varicose vein removal technique it is destined to become the primary surgical means of venous hypertension treatment for the foreseeable future.