Treatment Overview

A
laser is a highly focused beam of light. A doctor can
use a laser to treat
varicose veins. Laser heat damages a vein, which makes
scar tissue form. This scar tissue closes the vein. A closed vein loses its
source of blood and dies. After a year or two, the vein is likely to
disappear.

Simple laser treatment. Simple laser vein treatment is done on the outside of your skin. It can treat
spider veins and tiny varicose veins just under the
skin’s surface. Usually, more than one laser session is needed. They are
scheduled every 6 to 12 weeks, as prescribed by your doctor. (If you have poor
blood circulation feeding these tiny veins, the larger “feeder” vein must first
be treated with surgery, endovenous laser or
radiofrequency treatment, or
sclerotherapy.)

Endovenous laser treatment. Endovenous laser treatment can treat larger varicose veins in the legs. A laser fiber is passed
through a thin tube (catheter) into the vein. While doing this, the doctor
watches the vein on a
duplex ultrasound screen. Laser is less painful than
vein ligation and stripping, and it has a shorter recovery
time. Only
local anesthesia or a light
sedative is needed for laser treatment. (For ligation and stripping,
general anesthesia is used to put you to sleep.)

What To Expect After Treatment

You will be able to walk following the treatment, and recovery typically is short. You are likely to be able to return to
your normal daily routine after simple laser treatment.

After
endovenous laser treatment, you will wear compression stockings for 1 week or
more. To follow up, your doctor will use duplex ultrasound to make sure that
the vein is closed.footnote 1

Why It Is Done

Simple laser
treatment is done for small spider veins and tiny varicose veins. This is
sometimes a second treatment step, after a larger varicose vein has been
treated with surgery, endovenous laser or
radiofrequency treatment, or sclerotherapy.

Endovenous laser treatment is used to close off a
larger varicose vein, instead of using surgery to remove it.

How Well It Works

Simple laser treatment. Over the past 20 years, this type of laser treatment has
become quite safe and effective.

Endovenous laser treatment. Endovenous laser treatment closes veins
about 94 out of 100 times. It doesn’t work about 6 out of 100 times.footnote 2

If endovenous
laser treatment does not close a vein, you will need a second treatment.
Depending on what is available in your area, you may have choices between
another laser treatment, radiofrequency treatment, or sclerotherapy. In some
cases, vein surgery is recommended.

For the best chance of
success, be sure to have a doctor with a lot of endovenous laser
experience.

Risks

Side effects of laser treatment include:

  • Skin burns.
  • Skin coloring changes.
  • Feelings of burning, pain, or prickling after recovery, from nerve
    damage (less likely than after vein stripping surgery).
  • Small or
    large blood clotting in the vein or a deep vein (less likely than after vein
    stripping surgery).

The more experience your doctor has had with laser, the
less risk you are likely to have. Talk to your doctor about how often these
side effects happen in his or her practice.

What To Think About

If you are thinking of laser treatment,
consider some
questions to ask about varicose vein treatment. These
questions include: How much experience does the doctor have with the particular
treatment? How much do the exam and treatment cost? How many treatments does
the doctor think you will need?

For help deciding whether to have a procedure for varicose veins, see:

Varicose Veins: Should I Have a Surgical Procedure?

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

References

Citations

  1. Khilnani NM, et al. (2010). Multi-society consensus quality improvement guidelines for the treatment of lower extremity superficial venous insufficiency with endovenous thermal ablation from the Society of Interventional Radiology, Cardiovascular Interventional Radiological Society of Europe, American College of Phlebology, and Canadian Interventional Radiology Association. Journal of Vascular and Interventional Radiology, 21(1): 14-31.
  2. Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230-239.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer David A. Szalay, MD – Vascular Surgery

Current as ofMarch 20, 2017