September 20th, 2011
11:40 AM ET
To many mothers, it's just not fair. Nine months of pregnancy, giving birth to a child, and then there's a lasting, unwelcome reminder of the experience: Varicose veins.
The bulging, often painful swelling of blood in the legs can be treated, and a new study confirms that a less invasive method - widely available for about five years - also is slightly better at preventing varicose veins from returning.
The findings were published Monday in the Archives of Dermatology.
For decades, physicians have been removing varicose veins in a procedure that usually requires overnight hospitalization, called high ligation and stripping (HLS). Because most blood flows through veins deep in the leg's tissue, the body can continue on even with these veins removed.
Newer procedures leave the veins in place, but shut them down from inside, most commonly with the heat of a laser inserted by catheter.
Researchers designed the study to compare the laser treatment, called Endovenous Laser Treatment (EVLT), to HLS, and enrolled 400 initial patients, making it the largest study of its kind.
After two years, new varicose veins reappeared in 23% of the HLS-treated patients, and in 16% of the EVLT-treated patients. The study authors expect a greater difference when they complete their five-year patient follow up.
For doctors using EVLT to treat varicose veins, the study just confirms that this quicker out-patient procedure really works.
"We rarely do ligation and stripping anymore," says Dr. Joseph Ricotta, Assistant Professor of Surgery at Emory University School of Medicine. "99.9% of the varicose veins that we see in our office are treated with endovenous laser therapy. The only reason in our mind to do high ligation and stripping is if a patient had a certain anatomy that the laser therapy wouldn't work."
Those with a family history of varicose veins are at increased risk, and so are those who sit or stand extensively, have hypertension, are pregnant, or obese.
That's because pressure builds up in the leg's veins and breaks down the valves meant to stop blood headed toward the heart from flowing backward, and pooling in the leg.
"Compression, elevation, and exercise are the best things that you can do," says Ricotta. "Anything that alleviates the pressure in your veins is going to help preserve these valves."
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