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Surgery vs. Laser Treatment for Varicose Veins

Study Shows Vein Stripping and Laser Therapy Achieve Similar Results

Weighing Risks and Benefits

"This is an interesting paper, and gives a very similar picture that most other studies have shown," says Tristan R.A. Lane, MBBS, a vascular surgeon at Charing Cross Hospital and a researcher at Imperial College London, in an email to WebMD.

Lane reviewed the study but was not involved in the research.

"The overall message, as has become clear from most studies, is that the differing methods of vein treatment all work and provide good treatment if done well," Lane says.

Lane says because the study was started in 2004, it relied on an older laser technique that has since been advanced and may now provide better results.

He also notes that the kind of anesthesia used to perform the vein stripping in the study, called tumescent local anesthesia, is not a widely used technique and may have offered better results than a typical patient would get without it.

In the end, Lane says, the study won't change what he tells his patients.

"I usually explain that endovenous laser ablation [EVLT] provides a very good option, allowing patients to walk out of the clinic and go back to work the same or next day. I also explain that one treatment does not fit all and so we always consider other treatment methods," he says.

The study researchers agree.

Rass thinks EVLT may be best for younger patients because some research suggests that it's easier to fix return varicose veins after EVLT, and young patients are the most likely to need to have the surgery redone.

Vein-stripping, he says, may be best for older patients with larger veins or more advanced vessel damage.

But he says more research is needed to clarify which patients will see the most benefits, with the least recurrence, from each treatment.

"It will be the task for the future for us to characterize those patients having a risk for reopening and early clinical recurrence," he says. "This would help a lot to recommend the procedure with the best success for an individual patient."


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