Definition & Overview

Laser vein treatment is a procedure that uses laser technology to treat vein-related conditions or problems either for medical or aesthetic purposes or both. The veins play an important role in the body; as the heart pumps blood through the arteries, the blood makes its way back to the heart through the veins. Sometimes, however, the veins become swollen, leading to the development of varicose veins, which are most commonly found on the thighs or calves.

Although surgical options for treating varicose veins are available, most people are not willing to undergo surgery for a non-life threatening condition, hence the need for less invasive treatment options. This is where laser vein treatments come in.

Who Should Undergo & Expected Results

Laser vein treatment, which is typically carried out by aesthetic medicine practitioners who are specializing in laser treatment, is recommended for people who are suffering from varicose veins. Although varicose veins do not always require treatment, they sometimes cause pain or may become bothersome or unsightly, especially if they are bulging. Laser treatment relieves soreness and inflammation, as well as relieve irritated skin on top of the swollen veins.

There are two types of laser treatment for varicose veins. These are:

  • Simple laser treatment – This is non-invasive and does not require making a cut through the skin. It is commonly used for treating varicose and spider veins that are quite small and are near the surface of the skin. However, these treatments require several sessions that are typically spaced 6 to 12 weeks apart, depending on the severity of the problem. This is a tried and tested procedure that has been done for more than 20 years now, with high success and safety ratings.

  • Endovenous laser treatment (EVLT) – An endovenous laser ablation for varicose veins is necessary when the affected veins are severely swollen. The procedure is done by applying laser heat inside the vein, hence the word “endovenous”, which means “inside the vein.” This is considered as a safer and less painful alternative to other varicose or spider vein treatments such as ligation and stripping. Endovenous laser treatment requires only light sedation or local anaesthesia, whereas ligation and stripping require general anesthesia.

An endovenous treatment has 94% success rate and the biggest factor that affect this rate is the skill level of the doctor who performs the procedure. In cases wherein the desired result was not achieved, the treatment may be followed by another one, unless the patient prefers to try a different method of treatment, such as radiofrequency or sclerotherapy. If these options still fail, the last resort is to undergo vein surgery.

An endovenous laser treatment is a favorable alternative to surgery as it is minimally invasive and is typically performed on an outpatient basis.

How Does the Procedure Work?

Before the varicose veins treatment

  • The doctor will explain the procedure in detail, covering the pros and cons, the anaesthesia to be used, the expected results, the possible complications, etc. The patient is encouraged to ask questions and raise concerns to understand what the procedure entails.

  • Patients are typically given a form where they’ll indicate the medications or supplements they’re currently taking especially those that have a blood-thinning effect, existing medical conditions, allergies, etc.

  • Since the treatment is usually preceded by imaging scans such as an ultrasound to examine the vein, it is also important that the patient inform his doctor if he is allergic to the dye contrast material that is sometimes used in imaging procedures.

During the Procedure

  • Varicose or spider vein removal begins with the doctor numbing the area where the catheter will be inserted. The doctor also usually injects numbing medicine along the entire affected vein. The injections may cause a bit of discomfort, but once the numbing medication sets in, the procedure will progress without any discomfort.

  • Once the patient is ready, the doctor will make a small cut through the skin where the catheter will be inserted before it is slowly and carefully guided into the affected varicose vein. Once in place, the doctor will insert a laser fiber through the catheter that will produce heat along the entire length of the vein. At this point, the catheter will be removed, after which the vein will close up. As the laser fiber works within the vein, the latter will gradually shrink.

After the Procedure

  • The cut will be covered with a bandage.

  • The patient will be given instructions to wear compression stockings or bandages to compress the legs for the first few days or weeks following the procedure.

  • While wearing the compression stockings, the patient is not allowed to get the affected legs wet.

  • Patients will be encouraged to move around to promote normal blood flow throughout the body. Aside from swimming, the patient can return to his or her normal activities right after the procedure.

A follow-up visit is usually necessary to make sure that the patient is recovering well and that no complications have arisen. During a follow-up visit, another ultrasound will be conducted to check whether the affected vein has shrunk in size.

Possible Complications and Risks

Laser vein treatment or vein ablation comes with certain risks, including:

  • Infection

  • Bruising

  • Bleeding

  • Blood clot

  • Tenderness

  • Damaged nerve

  • Inflamed veins

  • Burns

  • Skin discoloration

  • Burning sensation

  • Prickling

Since these risks may spring from the use of laser energy, they are more likely to occur if the doctor administering the treatment is not experienced in handling and performing laser procedures. Thus, patients are encouraged to check the doctor’s credentials and years of experience before undergoing the procedure.

References:

  • Freischlag JA, Heller JA. Venous disease. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 65.

  • Goldman MP, Guex JJ, Weiss RA. Sclerotherapy: Treatment of Varicose and Telangiectatic Leg Veins. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011.

  • Nijsten T, van den Bos RR, Goldman MP, et al. Minimally invasive techniques in the treatment of saphenous varicose veins. J Am Acad Dermatol. 2009;60:110-119.

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