Varicose veins (and spider veins) can be symptomatic of potentially dangerous conditions such as DVT (deep vein thrombosis) which can put patients at risk of developing a pulmonary embolism (PE). Untreated, the underlying pathologies behind varicose veins can also cause pain, discomfort, swelling, skin thickening (lipodermatosclerosis), skin discoloration (stasis dermatitis), phlebitis (inflammation of the vein) and frustrating cycles of leg ulceration. Even apparently harmless spider veins (telangiectasia) may be associated with ‘hidden varicose veins.’
Over and above any underlying vascular problems, the appearance of varicose veins is often upsetting for patients who may suffer from a loss of confidence as a result, and stop wearing short garments. There are a number of treatments now available to rid people of these unpleasant-looking leg veins. The options available to you will be determined by various factors, including your overall health and the size, position and condition of the affected veins; and your weight, but endovascular laser ablation, ultrasound-guided sclerotherapy, sclerotherapy and ambulatory phlebectomy (micro-phlebectomy) are among the more popular modalities. Open phlebectomy and stripping of culprit veins and getting increasingly unpopular because of their invasiveness and lengthy downtime; but they are still widely practices in this country.
Thus at Spring of Youth Medical, Vein and Aesthetic Center, we employ the least invasive, lowest downtime procedures, for more certain and satisfactory outcomes. These are the four modalities mentioned above in various combination and permutation. Our choice of modality depends on the patient’s specific circumstances, body habits, age, gender and occupation. Endovascular Laser Ablation (EVLA) is ideal for reasonably straight veins that are large and not in the immediate vicinity of arteries and nerves. But what exactly does it entail and how effective is it, on both medical and cosmetic levels, and are there any notable side effects? The rest of this two-part article seeks to answer these questions.
What Happens During Laser Therapy for Varicose Veins?
Endovenous Laser Ablation (EVLA) or Laser Therapy is one of a number of alternatives to surgery for dealing with varicose veins; the treatment can have various names due to the branding of the laser equipment but the procedure is essentially the same. Before any vein is accessed through the skin, the target vein will be mapped by duplex ultrasonography and its course clearly marked on to the skin. After antiseptic cleaning and draping of the leg, local anesthetic is applied to the skin at the site of vein access and a needle is introduced into the vein through the numb area, guided by ultrasound. A fine guide-wire is inserted through the needle followed by a catheter and then by a longer J-wire and catheter until the furthest point of the vein to be treated is reached. Finally, the guide wire is replaced by an optic laser fiber.
Tumescent – a solution of anesthesia, with a small dose of adrenaline, in cold saline – is placed around the culprit vein as an analgesic, insulator and coolant to prevent surrounding tissues from being adversely affected in any way, and to add to the comfort of the procedure.
The laser light is then turned on and steadily pulled back along the vein, shining its light onto the intima of the vein, causing the vessel to shrink and close up.
Is Laser Therapy Used to Treat Spider Veins?
All types of laser treatments of leg veins make use of a focused beam of light to ablate the unwanted vessels; but whereas most varicose veins are large and deep than skin level, and do better with endovenous laser treatments (in which the laser is inserted into the offending vein), spider veins require a different type of laser, since the wrong choice can have unintended consequences. Laser for treatment of spider vein needs to use a different wavelength and different intensity and should not penetrate deeper than the spider vein under the surface of the skin. This may require several (up to 6 times) applications of laser with increasing cost and inconvenience. Laser treatment has been used to treat spider veins for over 30 years and patients will not normally require anesthetic due to the design of the lasers which normally incorporate a cooling system, in some cases, but it may be a little uncomfortable. Simple laser treatment can be carried out in a clinic and each session usually lasts ten to twenty minutes. But as mentioned, the treatment may have to be repeated up to six times fir a satisfactory result. And like all veins and treatments, the veins may return at the site or close by.
Sometimes sclerotherapy will be offered as an alternative treatment to simple laser therapy for spider and reticular veins (a little bigger than spider veins). This procedure involves the injection of a mild agent into the vein which will cause it to collapse and close and become re-absorbed and disappear over time. Spiders may require two-three treatment to disappear completely.
The Spring of Youth Medical Group is pleased to offer EVLT™, an endovenous laser treatment for the treatment of suitable varicose veins. To find out more about our range of cosmetic therapies, please visit www.springofyouthmedical.com or call us on (228) 875-0885.