For some, varicose veins are more of a cosmetic concern than health, because the sight of these bluish, bulging, swollen and twisted veins that run beneath the skin surface is not tolerated, and symptoms usually associated with these veins are absent. For others, the symptoms are so severe that they disrupt the resumption of normal life; causing leg heaviness, muscle cramping, swelling, restless legs, and aching pain that may gets worse after sitting or standing for a long time. Vein size is often not related to the presence or severity of symptoms.

Leg varicose veins form due to the pressure exerted by the blood that pools in veins. The heart sends blood through arteries down to the legs to supply them with oxygen and nutrients. Once that is done, the blood returns back to the heart through veins. Muscle contractions and a network of one-way vein valves help the blood go upwards against the gravitational pull. As we age, vein valves start to deteriorate, sometimes to the extent that blood leaks and pools in the veins, especially in the lower extremities, the legs. The condition is known as venous reflux. Deeper veins are less prone to become varicose veins, because pumping of blood in these veins is assisted by muscle contractions.

Until the first few years of this century, varicose vein treatment meant surgical intervention, hospitalization, and general anesthesia, because they involved painful procedures, known as vein ligation or stripping. Thanks to advancement in science and medical technologies, nowadays there are minimally invasive options for varicose vein treatment. These treatment modalities, often covered by health insurance plans, do not require hospitalization and are performed in doctors' offices or vein clinics. The VNUS closure procedure and EVLT (endovenous laser treatment) are two such modalities; in fact, they are the most advanced medical technologies currently available for varicose vein treatment. Both procedures are endovenous in their approach; meaning that veins are accessed and treated from inside the veins.

According to recent studies, endovenous vein ablation have proved to be as effective as conventional surgical management, and have led to increased patient satisfaction. They do not leave behind any scars; do not require general anesthesia; recovery is faster, and patients resume their near normal activities immediately after the procedures.

During an endovenous vein ablation procedure, a catheter is inserted directly into the targeted vein near the knee and guided up the thigh using Ultrasound Duplex imaging. Ultrasound imaging helps the doctor identify the diseased sections of a vein and precisely position the catheter in the indicated locations. The heat delivered by the catheters causes the vein wall to shrink and seal. This is known as thermal vein ablation or closure. Varicose vein treatment with these enovenous vein ablation procedures is performed with local anesthesia and takes less than one hour.

According to recent published studies, patient satisfaction with the VNUS closure system is the highest compared to others that use lasers for endovenous ablation; producing less pain, bruising, and complications. The main reason that some doctors use endovenous laser systems is for increasing their profit margin. The VNUS closure system uses expensive disposable radiofrequency generating catheters; whereas, the competing endovenous vein closure systems use reusable laser generating catheters.

Injection of local anesthesia around the abnormal vein is the most bothersome part of the procedure because it requires multiple injections along the vein. Actual varicose vein treatment with either laser or radiofrequency is not painful. Patients walk out of the clinic wearing compression hosiery. The most common side effects of the endovenous ablation procedures are pain and bruising related to heating of the vein and the inflammatory reaction secondary to heating. This usually lasts 7 to 10 days and is controlled with NSAID medications. Within one week, the targeted varicose vein should be successfully closed. Of course, a follow up ultrasound examination is essential in order to assess the treated vein and to check for adverse outcomes.

Endovenous ablation techniques can be successfully applied to medium to large size veins. Unfortunately, veins larger than 16 mm need surgical approach; either ligation or stripping. The catheters used in the endovenous vein closure techniques are simply not thick enough for these veins. Enovenous systems are also not suitable for varicosities that branch outwards from the saphenous veins. Saphenous veins are the largest and longest leg veins. Only 10 to 15% of small branch varicose veins and spider veins regress after endovenous vein closure. Fortunately, there are other convenient minimally invasive procedures for these veins. Branch varicose veins are best treated with foam sclerotherapy; whereas, sclerotherapy is the gold standard for spider vein treatment. Sclerotherapy techniques use a tiny needle to inject a medicine, in the foam or fluid form, directly into the diseased veins.

Click the following links for more information on endovenous ablation" and various other varicose vein treatment options. They will take you to the informative website of Nu Vela Esthetica, a premier Los Angeles Vein Clinic and Cosmetic Laser Surgery Center.

Author's Bio: 

Dr. R. Dishakjian is the medical director of Nu Vela Esthetica. Dr. Dishakjian, a phlebologist and cosmetic surgeon, is specialized in minimally invasive vein treatment and cosmetic surgery procedures.