Two Varicose Veins Treatments Equally
MONDAY, Sept. 19 (HealthDay News) -- Although laser treatment
and surgery are both effective in treating varicose veins, it
appears that recurrence of one form of the problem is more common
with the laser treatment, German researchers report.
Varicose veins are twisted and enlarged veins that usually occur
in the legs. As many as 35 percent of adults suffer complications
from varicose veins, usually when the leg's so-called great
saphenous vein becomes blocked, affecting blood flow. Standard
treatments include removing the vein either with surgery or a laser
procedure, which can prevent complications and improve quality of
life, researchers say.
"Our opinion is that both procedures can be equally offered to the patients with great saphenous vein insufficiency," said lead researcher Dr. Knuth Rass, from Saarland University Hospital in Homburg.
However, patients should be informed that there might be a risk
for a higher rate of clinical recurrences beyond two years after
the laser treatment, he said.
Bulging varicose veins -- often purple and dark blue -- are
usually seen in the legs or feet because standing puts more
pressure on them. In some people, the problem may simply be
cosmetic, but in others it can cause aching and pain, muscle
cramping, itching and other symptoms. When accompanied by skin
ulcers near the ankle, varicose veins can even signal a serious
The report was published in the Sept. 19 online edition of the
Archives of Dermatology.
For the study, Rass and colleagues randomly assigned 346
patients to undergo either a surgical procedure called high
ligation and stripping, or a laser treatment called endovenous
The surgical procedure involves tying off the vein, which runs
between the hip and the foot, through a small incision at the hip.
In the laser procedure, a catheter is inserted into the vein and
the laser's burst of light causes the vein to disappear.
During two years of follow-up after the procedure, the
researchers looked for recurrence of the condition, severity of the
condition, blood flow in the vein and other side effects. They also
evaluated how satisfied patients were with each procedure.
Overall, recurrence was 16.2 percent for those who had the laser
treatment and 23.1 percent of those who had surgery. But ultrasound
revealed that many more patients who had the laser treatment
developed one form of the condition called duplex-detected
saphenofemoral reflux, where blood flows backward through the vein
(17.8 percent of laser treatment patients versus 1.3 percent of
Both treatments equally improved the severity of the disease and
the patient's quality of life, and patients were satisfied with
both treatments, the researchers noted. "Ninety-eight percent of
the study population would undergo each treatment once again, when
asked two years after treatment," Rass said.
Although there were more minor side effects with the laser
treatment, including pain, it did produce better blood flow in the
legs and was associated with faster recovery and a better cosmetic
outcome, compared with surgery, the investigators found.
Commenting on the study, Dr. Enrique Ginzburg, a professor of
surgery at the University of Miami Miller School of Medicine, said
that "it makes sense that the two procedures have similar
Ginzburg noted there are other treatments, including
radiofrequency-powered segmental thermal ablation and another laser
treatment called radial laser fiber, which uses less power, thus
reducing pain. There is also a technique that involves a spinning
catheter that destroys the inside of the vein causing it to clot
off, he said.
For people who have mild cases of varicose veins, experts note,
doctors may instead recommend self-care (exercising, losing weight
and avoiding tight clothes) or wearing compression stockings to
help the blood flow more efficiently.
But there are often medical reasons, not only cosmetic reasons,
for having procedures to treat varicose veins, Ginzburg noted. "In
reality, it's a combination of both. Varicose veins are painful as
they get bigger. At the same time they are unsightly, so it's not
just a cosmetic procedure, it's a therapeutic procedure," he
Patients are charged about the same for each of these
procedures, Ginzburg said. The average cost is about $2,000
whichever procedure a patient opts for, he noted.
As with all surgeries, vein stripping poses some risks,
including that of blood clots, infection and nerve damage. Laser
procedures for varicose veins also carry a small risk of infection,
nerve inflammation and/or damage and blood clots.
Some patients, including pregnant women, should not undergo vein
stripping. And as with any surgery, it is also crucial to check the
background of the varicose vein specialist beforehand. Experts
recommend using a board-certified vascular surgeon.
For more information on varicose veins, visit the
U.S. National Library of Medicine.
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