One of the biggest advancements I’ve seen in 10 years of private practice is how endovenous (inside the vein) laser therapy is replacing surgical treatment of varicose veins. Ligation and vein stripping for varicose veins had been the treatment of choice for many years. When the valves in the veins of the lower leg don’t work well, this leads to varicose veins. To get rid of them used to mean a visit to the vascular surgeon for vein stripping or other more invasive treatments. Now, endovenous laser treatment is a revolutionary advance in the treatment of varicose veins.

How do they work? Endovenous laser fibers are inserted in the vessel using an ultrasound for guidance. The laser heat causes shrinkage of the vein wall collagen. It is an extremely easy procedure that takes about 15 minutes and is done by a dermatologist in their office. It’s almost bloodless and patients can go back to work that day wearing light compression hose with very little discomfort after the procedure.

The other piece of great news is that recurrence rates with endovenous laser therapy are lower compared to the older therapies. Endovenous laser therapy is used to treat large varicose veins; while smaller varicose veins and spider veins, may still be treated by sclerotherapy (injection of a salt solution directly into the vein) and other modalities. Those large, bulging, blue, snake-like varicose veins that my patients hate may be a thing of the past.

- Dr O.