Varicose vein - noninvasive treatment

Alternative Names: Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose vein therapy

Varicose veins are swollen, twisted, painful veins that have filled with blood. They usually develop in the legs. Your doctor may be able to treat them in noninvasive ways instead of vein stripping, the traditional surgery for this problem.

Description of Procedure

Normally, valves in your veins keep your blood flowing forward so it does not collect in one place. But the valves in varicose veins may be damaged, deformed, or missing. As a result, the veins stay filled with blood, especially when you are standing.

When you stand up, you can see varicose veins as large, bluish vessels that may feel like a "rope."

Nonsurgical treatments for varicose veins can be performed in a doctor's office or clinic. You will receive local anesthesia to numb your leg. You will be awake but will not feel pain.

Sclerotherapy is one common treatment for varicose veins. Your doctor will inject salt water (saline) or a chemical solution into the varicose vein. The vein will harden and then disappear. Sclerotherapy works best for small spider veins.

Newer methods are also being used to treat varicose veins. One is called radiofrequency ablation. Another is called endovenous laser ablation. Each of these methods uses intense heat to treat the vein. During these procedures:

• Your doctor will puncture the varicose vein. Ultrasound (a painless way to see inside your leg) will guide your doctor during the treatment.
• Your doctor will thread a a flexible tube (catheter) through the vein up to your groin. The doctor will inject a special solution into your vein to numb it.
• Intense heat will reach the vein through the catheter in the vein. The heat will close off and destroy the vein. The vein will disappear over time.

These newer procedures can treat varicose veins in the upper thigh only.

Risks of Varicose vein - noninvasive treatment

These treatments are generally safe. Ask your doctor about specific problems that might occur.

The risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems

The risks for any procedure are:

• Bleeding
• Bruising
• Infection

The risks of endovenous laser ablation are:

• Blood clots
• Damage to the nerve
• Failure to close the vein
• Opening of the treated vein
• Paresthesias (prickly, tingly skin)
• Pulmonary embolism (a blood clot in your lungs)
• Skin burns from the heated catheter
• Thrombophlebitis (inflammation in a vein with a blood clot that attaches to the vein)

The risks of sclerotherapy are:

• Blocked blood flow in the treated vein
• The solution leaks out of the vein into other tissue (this can damage surrounding tissue and cause ulcers to form)
• Vein irritation

The risks of any treatment for varicose veins are:

• Bruising or scarring
• Nerve injury
• Return of the varicose vein over time

Review Date: 1/25/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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