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Varicose vein - noninvasive treatment

Definition

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.

Alternative Names

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

Description

Normally, valves in your veins keep your blood flowing so it does not collect in one place. But the valves in varicose veins are either damaged or missing. This causes the veins to remain filled with blood, especially when you are standing.

Nonsurgical treatments for this problem are done in a doctor's office or clinic. You will receive local anesthesia to numb your leg. You will be awake but not feel pain.

Sclerotherapy is one common treatment. Your doctor will inject saline (saltwater) or a chemical solution into the varicose vein. The vein will harden and then disappear.

Newer methods are also being use to treat varicose veins. One is called radiofrequency ablation. Another is called endovenous laser ablation. Each of these 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 catheter (a flexible tube) 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.

Risks

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
• Infection
• Bruising

The risks of endovenous laser ablation are:

• Blood clots (call your doctor if your feet or legs swell or get warm or hot)
• Pulmonary embolism (a blood clot in your lungs)
• Thrombophlebitis (inflammation in a vein with a blood clot that attaches to the vein)
• Paresthesias (prickly, tingly skin)
• Opening of the treated vein
• Skin burns from the heated catheter

The risks of sclerotherapy are:

• Vein irritation
• 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.

The risks of any treatment for varicose veins are:

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

Review Date: 2/9/2009
Reviewed By: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.