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Approximately 25 million Americans have unsightly, bluish varicose veins in the leg. Varicose veins occur when the walls of the veins or the valves are weak. Blood is supposed to flow through the veins and to the heart, but when a valve in a vein becomes damaged, blood pools, flows backward, and puts pressure on vein walls -- causing bulging, painful varicose veins.
The good news is that now there are more options than ever to remove them, including a new procedure called radio frequency closure that treats varicose veins by heating them, causing the tissue to shrink and the vein to close. Unlike vein stripping, it is minimally invasive -- you can go out in shorts the same day, rather than needing a two-week recovery.
To perform this procedure, the doctor first maps the vein and numbs the area with a local anesthestic. The doctor then nicks the skin behind the knee and threads into the vein a small tube called a catheter that delivers radio-frequency energy to the vein wall, causing the vein to contract and seal shut. Once this happens, nearby healthy veins take over.
Another option for varicose vein removal is called sclerotherapy, or injection therapy. During this procedure, a special solution is injected into the vein to force it to close. Some doctors are also using lasers to get rid of varicose veins.
Sclerotherapy is most commonly used to treat larger spider veins, with lasers used to treat finer veins, says Bruce Katz, MD, director of the JUVA Skin and Laser Center and associate clinical professor of dermatology at Columbia University College of Physicians and Surgeons, both in New York.
"There is no scarring from any of these procedures," he says. "We do this literally every day, and veins are gone for good. Women with road maps on legs, who never wore a bathing suit or shorts, now go to the beach regularly. It's a really common problem, and now we can get rid of them, which is great."
In the latest addition to varicose vein treatments, researchers are testing a new laser procedure. The procedure is performed with the help of ultrasound imaging. During the treatment, the large leg vein -- called the saphenous vein -- is closed with the help of the laser. That causes the smaller veins to shrink and improve in appearance. Other healthy veins take over to carry blood from the leg, re-establishing normal blood flow.
By comparison, other varicose vein procedures -- like vein stripping -- fail more often than this laser technique, according to researchers that presented their findings at the annual scientific meeting of the Society of Interventional Radiology in Salt Lake City, Utah, in April 2003. Those procedures also require general anesthesia, and up to two weeks recovery -- and pain, bruising, and scarring are common. In addition, researchers say that even when you remove the vein with surgery, there is a 10% to 25% chance of recurrence as opposed to a 7% chance of recurrence with the new, less invasive laser procedure.