Study: For varicose veins, quicker treatment just as good
September 20th, 2011
11:40 AM ET

Study: For varicose veins, quicker treatment just as good

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."

soundoff (31 Responses)
  1. Philippe

    I have some of these veins in my left testicle, talk about painful. Would this laser treatment affect my fertility?

    September 20, 2011 at 16:37 | Report abuse | Reply
    • twotired

      I don't know about the treatment, but variocele may reduce your fertility.

      September 21, 2011 at 08:40 | Report abuse |
  2. Bradley

    Laser hear that treatment is, at this point, old technology for this condition. The newest and best procedure is Radio Frequency Ablation. Patients can potentially be burned by the heat from the laser procedure and recovery time is considerably longer. I am told that RF Ablation patients walk out of the office where the procedure is typically done with immediate relief. Comparing the two, Radio Frequency Ablation seems much better.

    September 20, 2011 at 23:59 | Report abuse | Reply
    • Shanno

      I'm having ablation done on two veins in left leg in October. Wish me luck!

      September 21, 2011 at 13:44 | Report abuse |
  3. Bradley

    My comment above should read "I hear that laser treatment is..."
    Apologies for the typo.

    September 21, 2011 at 00:02 | Report abuse | Reply


    September 21, 2011 at 01:30 | Report abuse | Reply
  5. Carol Fuller

    I had this procedure done 2 years ago in Johnson City, TN...I walked out of the Dr office afterwards and right back to work...I had no pain after but did have considerable bruising and had to wear compression stockings for weeks, which I was told to expect...I had 3 ugly veins removed from one leg and it looks wonderful!!!!! Today, no one would ever know..and even better, my insurance covered it because it became a medical issue, not cosmetic. I would recommend this procedure for anyone with a varicose vein problem.

    September 21, 2011 at 13:37 | Report abuse | Reply
  6. Arlene

    I had a Radio frequency Ablation on both legs two years ago. I did everything I was told to do, wearing those old lady looking compression stockings all the time. Itwas a total failure. My varicose veins are still there. The spider veins are still there.There's gotta be a better way.

    September 21, 2011 at 14:05 | Report abuse | Reply
    • Dr . Ken Harper

      Sorry to hear about your disappointment with endovenous ablation. I have done over 4,000 RF ablations since 2000. RF closes the treated segment of vein in almost every case. I have an observations– the original diagnosis of your underlying problem may have been missed, the doctor treated the saphenous vein but neglected treating the symptomatic veins that brought you to the doctor in the first place. I suggest you get a second opinion with a board certified phlebologist. Check out the American College of Phlebology website for a doctor near you. Thanks and have a great day.

      September 21, 2011 at 20:52 | Report abuse |
  7. Melissa Gwozdz

    Thank you for posting this article. Many people are unaware that pregnancy can lead to varicose veins.

    According to a report by Swiss Medical Weekly, 30 percent of women develop varicose veins from their first pregnancy and 55 percent of women develop varicose veins from their second pregnancy. Medical compression stockings can help prevent varicose veins, spider veins and swollen ankles and feet during pregnancy. As a global leader in medical compression stockings, we find that many women are unaware of the steps they can take to keep their legs healthy during pregnancy. At BabyYourLegs.com, we have posted some tips for keeping legs healthy during pregnancy as well information about how women can protect themselves from a Deep Vein Thrombosis during and after their pregnancy.

    -Melissa Gwozdz, Communications Coordinator, SIGVARIS North America

    September 21, 2011 at 14:55 | Report abuse | Reply
    • MommaJ

      Surely there are other preventive methods, such as proper exercise and diet.

      It doesn't make sense biologically and anthropologically, that we've developed these bodies over millions of years as natural animals, basically, but now require – for a huge percentage of the population – to take measures to carry our young without serious health problems.

      What's the root cause? Lack of vitamin D or vitamin E? Lack of exercise? I'm quite certain that our ancestors did not, for millions of years, require special stockings to safely and healthily bear young.

      September 22, 2011 at 14:04 | Report abuse |
  8. EVLT

    I got an Endovenous Laser Therapy (EVLT) at another clinic in Chicago, called USA Vein Clinics. They did such a great job, and I can't recommend them enough! The whole procedure took only 10 minutes. No hospitalisation, no pain. That's just a miracle! You can use this phone number to give them a call: 888-894-9464.


    February 27, 2012 at 15:12 | Report abuse | Reply
  9. Nurse Yna

    I'm a nurse and I used to suffer from this varicose veins for years. It's been terrible, long periods of standing is killing me. But it is part of my job. Before I used to go home straight to bed put my feet up and realized I was in tears. Fortunately, a lot of help came out through modern technology. My friend advise me to visit this site http://veinstreatment.org . And boom! It did help a lot.

    May 30, 2012 at 19:57 | Report abuse | Reply
  10. Gema

    My varicose veins is getting bigger and bigger now. at first I did not take it seriously but as the time goes by, it becomes my problem as my legs look so disgusting. I am already calling one of the best clinics in Canada "Varice.ca" hope the doctor in charge is going to help me get rid with it.

    October 29, 2012 at 15:39 | Report abuse | Reply
  11. Vivian Bettle

    Varicose veins are very unsighty but it can be solved by some topical agents like hiruoid. ^

    <a href="Please do go look at this useful internet page

    November 25, 2012 at 11:17 | Report abuse | Reply
  12. Rachel

    I started developing varicose veins about 6 months into my first pregnancy. They became very painful and I became frustrated with them. I started researching different treatment options and did not want to consider surgery at all. I found USA Vein Clinics and made an appointment. I went in for the procedure that only lasted about 20 minutes and I had no pain and no down time at all. They used a laser for the procedure and I would definitely recommend this type of treatment over everything else. Needless to say my varicose veins are completely gone and I could not be happier with the results I got. I would most definitely recommend checking them out. I believe they have multiple locations across the US. I went to the one in Brooklyn, NY. The staff was great! usaveinclinics.com

    November 27, 2012 at 19:13 | Report abuse | Reply
  13. Jennifer

    I just got my varicose veins removed at the usa vein clinic a little over a week ago. I definitely recommend getting the laser treatment done and not surgery. My procedure was only about 15 minutes. I no longer have to deal with swollen painful varicose veins. I am also a lot more confident about myself now that I don't have to hide my legs!

    December 7, 2012 at 13:04 | Report abuse | Reply
  14. Shu Hames

    Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. ..;....

    Good day <http://www.healthdigest101.com

    July 8, 2013 at 23:24 | Report abuse | Reply
  15. Dr. Yan Katsnelson, MD with USA Vein Clinics

    In the past, varicose veins were treated with a surgical procedure called vein stripping, where the vein was completely removed from the leg. Today, Endovenous Laser Therapy (EVLT) is used to deliver laser energy into the malfunctioning vein to seal it closed. It's precise, painless, and quick. How? Learn it here: http://www.usaveinclinics.com/evlt-varicose-veins-treatment/

    October 24, 2013 at 10:09 | Report abuse | Reply
  16. Shilpa Roy

    I got EVLT treatment for varicose veins by DR. Abhilash at http://interventionsinradiology.com/ it was a splendid treatment & it took a minimal recovery time. It is the best treatment with no pain & surgery i personally recommend people to go with this treatment. After the treatment we can resume to our normal activities.

    April 7, 2015 at 02:51 | Report abuse | Reply
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    One year ago, I had suffering from Spider veins(Red,purple) on both legs . I was taking various treatments. but spider vein still there. Please give me the better suggestion.

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    With new technologies there is still a new variety of deceases associated with it and we are all paying the price of it.

    Varicose Veins

    May 4, 2018 at 07:38 | Report abuse | Reply
  21. Brandon Jeronimo

    Awesome info, thank you! My varicose veins have started bothering me so I have a consult scheduled in Chicago IL. Are ambulatory phlebectomy, endovenous laser treatment, and sclerotherapy all effective treatments for varicose and spider veins?


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