March 30, 2004 (Phoenix) -- With summer fast approaching, many people look forward to shedding winter's layers of clothing for shorts and swim suits, but for many people whose legs are marked with varicose veins these items are dreaded wardrobe choices. But help is now available.
A new minimally invasive laser surgery procedure may change the lives for an estimated 25% of adult women and 15% of adult men with varicose veins.
Speaking at this year's Society of Interventional Radiology meeting, Kenneth Todd, MD, an interventional radiologist at Southwest Vein and Laser Center in Dothan, presented results from a study of 270 people with visible varicose veins treated with a minimally invasive laser surgery treatment.
In the study the success rate a month after treatment with laser surgery was 100%. And a year later, 261 of the 270 patients had no evidence of varicose veins.
Varicose veins are prominent, rope-like veins that have lost their ability to recirculate blood. As a result of malfunction of these veins, gravity causes blood to pool in these bulging, blue-looking veins which can be visible at the surface of the skin.
Varicose veins can be uncomfortable causing itching, throbbing, swelling, and leg fatigue and heaviness. In general having a family history of varicose veins is a risk factor -- but other factors include being a female, obese, or pregnant. More severe cases can also be associated with skin ulcerations.
Until recently the treatment for varicose veins was surgery that removed the incompetent veins or cut off blood flow to the veins by injecting chemicals into the vessel, a procedure called sclerotherapy. Removal of the veins, called stripping, is done under general anesthesia and involves an incision in the groin as well as many small incisions in the lower leg. These procedures require a hospital stay and are often painful.
Robert Vogelzang, MD, professor of radiology at Northwestern Medical School in Chicago tells WebMD that the problem with both of these older procedures is that they also often don't solve the problem and patients will require repeat treatments. Simply cutting or stopping the blood supply to the surface can result in other veins becoming just as twisted and diseased as the original vessels, he says.
"When you destroy the whole lining of the vein, you don't have a chance for new collateral veins to grow," he says. Vogelzang, who is a past president of the Society of Interventional Radiologists, says that's where laser surgery has an advantage.
In the procedure, a small, spaghetti-thin catheter is inserted into the vein. Laser energy is applied to the inside of the malfunctioning vein and the heat seals the vein closed. Other healthy veins take over take over normal blood flow in the leg.
The treatment is also patient friendly because it can be done on an outpatient basis, the incision can be covered with a Band-Aid and the procedure pain is so mild that is it handled with over-the-counter pain relievers.
Todd says, he agrees with Vogelzang and says that when laser surgery is used to treat varicose veins other varicose veins reappear in about only 4% of those treated. With stripping plus sclerotherapy varicose veins reappear in about 30% and for sclerotherapy alone the recurrence rate is more than 70%.
Robert Min, MD, director of Cornell Vascular and assistant professor of radiology at Weill Medical College of Cornell University, is widely considered the leader in laser treatment of varicose veins. He says that in his last 500 patients, "I have not had a single failure."
Neither Min nor Vogelstang were involved in Todd's study.