Doctors have found a new non-surgical treatment that uses lasers to zap the unsightly and painful varicose veins that plague the legs of about half of those over 50.
The new technique, performed on about 250 patients worldwide, will be announced today at the 26th Annual Scientific Meeting of the Society of Cardiovascular and Interventional Radiology in San Antonio, Texas.
Dr. Robert J. Min, the interventional radiologist from Weill Medical College of Cornell University in New York who pioneered EndoVenous Laser Treatment (EVLT) said that the new procedure is simpler, cheaper, and has fewer side effects than other treatments. And the procedure is not just for cosmetic reasons.
"Unlike spider veins, when you have varicose veins, there is fat, heaviness, swelling and in extreme cases, the skin can break down," Min told Good Morning America. The procedure is gaining in popularity and he expects thousands of procedures to take place within the next year.
The procedure takes half an hour, and although some patients have a little tenderness, they can return to normal activity immediately, he said.
Common Problem Varicose veins affect one of every two people 50 or older, and about 15 percent of men and 25 percent of women overall, the Society of Cardiovascular and Interventional Radiology says. Pregnant women and women with a family history of varicose veins are at highest risk to develop the condition.
Experts have also named obesity, jobs that require sitting or standing for long periods of time, birth control pills, pregnancy and hormone replacement therapy as culprits in making varicose veins worse.
Though simply a cosmetic issue for some, varicose veins can also cause aches and pains, cramp and leg swelling. A medical study conducted 15 years ago in Switzerland showed that those with varicose veins also stand a 50 percent higher risk of developing blood clots or leg ulcers.
The unsightly veins seen on the surface of the leg are actually caused by an incompetent saphenous vein, the main vein that runs the length of the inner leg. Valves in the vein become weak and allow the blood to flow backward, or pool. Instead of carrying the blood back to your heart, the varicose veins let the blood fall toward your feet.
Then, branch vessels of the vein which are close to the skin's surface become enlarged and appear twisted and ropelike. The result: unsightly bumps and rope-like veins protruding from the legs like a roadmap.
A Leg Up on Treatment
The new procedure marks the first time that a laser has been used to treat varicose veins in the legs, though lasers have been used to zap tinier "spider veins," Min said.
Currently, hundreds of thousands of operations are done for varicose veins a year in the United States. Varicose vein sufferers either get surgery to remove the vein, or injection therapy to close it up.
Surgical ligation, or removal of the saphenous vein in the leg, fails about 10 percent of the time. Patients are required to be placed under anesthesia, there is a two-week recovery period, and it often takes a second procedure to really see results.
Many patients experience pain, bruising and scarring as side effects of the surgery. Another technique used to battle varicose veins is ultrasound-guided sclerotherapy, which involves injecting an irritant into the saphenous vein to close it up. It only works permanently about 50 percent of the time.
The new laser treatment, which costs about $2,000, can be done on an outpatient basis using a local anesthetic such as Lidocaine, Min said.
Details on Procedure To be a candidate for EVLT, a patient must have varicose veins that are the result of an incompetent saphenous vein.
A patient comes in lies on an examining table and has an IV placed in their saphenous vein at knee level. The skin is just nicked when a laser fiber is inserted into the vein, and it goes up to the groin area. The doctor then numbs the vein, and turns on the laser. Its highly targeted energy heats and seals the vein shut.
After the procedure, the branch veins near the surface usually shrink, but in other cases, patients return for a few sclerotherapy treatments, which successfully eradicate the problem, once the saphenous vein has been sealed off. Patients are told to avoid vigorous gym workouts that day, but otherwise they are ready to go back to work.
About 250 people have had the procedure in the past 18 months, with a success rate after the first treatment of 99 percent, Min said. After a one-year follow up maybe 97 percent have remained closed, though the recurrence rate could rise in the next three to five years.
The procedure costs about $2,000, which is about a quarter of the cost of conventional surgery. Some insurance companies cover it, Min said. It is becoming more widely available, with about 20 physicians performing it currently and around 100 expected to be offering it by next year.
Cornell Vascular is one of five centers in the United States and 10 worldwide offering EndoVenous Laser Treatment. More than a dozen new sites will be in operation shortly and physicians are now being trained in the technique.