What is Laser Varicose Vein Treatment?
Varicose veins are oversized, twisted veins that mainly appear on the legs and feet. They occur when veins (the blood vessels that transport blood with waste products and oxygen-depleted blood from the body to the heart) do not perform their duties properly. This causes the blood to pool instead of flowing smoothly back to the heart. Previously, varicose veins were treated surgically, but advances in technology have enabled less invasive techniques. Among these, laser surgery has achieved importance as an extensive approach, offering targeted treatment with greater precision and without any large cuts.
Before knowing in detail about laser varicose veins treatment, it is important to get to terms with the issue that causes them. The root cause of varicose veins is reduced blood flow, termed venous insufficiency, where the one-way valves fail. The key characteristics of varicose veins include
Raised, twisted, and bulging veins that are often blue or dark purple in colour. These are frequently found in calves, thighs, and sometimes in feet. The signs of varicose veins include heaviness, aching, swelling, itching, or a burning sensation. If left untreated, varicose veins may lead to more serious circulatory diseases like venous ulcers and deep vein thrombosis (DVT).
For understanding the working of laser varicose veins, knowing the anatomy of the venous system is important. Veins carry deoxygenated blood back to the heart. Superficial veins that are visible through the skin are prone to varicosities, while deep veins handle the majority of blood returning. The objective of the laser varicose veins is to target the improperly functioning superficial veins.
Laser treatment for varicose veins depends on highly focused light energy to close the affected veins. This process is called Endovenous Laser Therapy (EVLT) or endovenous laser ablation (EVLA). The energy produced from the laser is absorbed by the blood flowing inside the vein and the wall of the vein. This causes the vein to collapse and get sealed automatically. Over time, the treated vein is absorbed by the body, and the blood flow is allowed to change its pathway to healthy veins.
Key characteristics of laser varicose treatment surgery include accuracy. The laser only targets the affected varicosed veins and does not cause any disturbances in the nearby surroundings. It is minimally invasive, unlike traditional surgeries; large cuts are not required. The wavelength and intensity at which the laser is delivered are adjusted according to the needs of the patient.
Laser technology keeps getting better on a yearly basis, with modern systems allowing better penetration, decreased discomfort, and shorter surgery time.
Laser varicose vein treatment can be divided into two main types, namely, Endovenous laser therapy (EVLT), also known as endovenous laser ablation (EVLA), and Simple laser treatment (surface laser), also known as transdermal laser therapy. Each type of laser treatment uses specific wavelengths that are designed to increase the rate of absorption by hemoglobin in the blood, also decreasing damage to nearby tissue.
Laser treatment works on the principle of selective photothermolysis (That is, the laser only targets the affected varicosed veins and does not cause any disturbances in the nearby surroundings). Key technical considerations are wavelength; the common wavelengths utilised are from 810 nm to 1470 nm, which are for different vein sizes and depths. Laser energy is measured in joules per centimeter, which are carefully calculated to make sure veins are properly closed.
While laser varicose vein treatment has a wide variety of uses, some patients are most suited. The characteristics that are considered include the size of the vein, usually medium to large superficial veins respond quickly, and vein anatomy, where straight veins are easier to treat than highly tortuous veins. Laser varicose vein treatment is known to cause less skin damage in comparison to other techniques that ensure better energy penetration. In terms of medical history, patients without any active infections, like deep vein thrombosis and other clotting disorders, are considered to be ideal candidates.
Duplex ultrasonography is an imaging technique that is used for in-depth evaluation of the vascular system. This usually helps in determining which veins are malfunctioning and helps in guiding the planning of laser varicose vein treatment.
Laser varicose vein treatment has widely advanced over the last two decades, with the use of lasers over longer wavelengths becoming an increasingly useful option. This is useful for uniform distribution of energy and making sure that treatment has greater efficacy, and is classified as first-generation lasers, second-generation lasers, and third-generation lasers.
| Procedure Name | Laser Varicose Vein Treatment |
|---|---|
| Type of Surgery | Minimally invasive procedure |
| Type of Anesthesia | Local Anesthesia |
| Procedure Duration | 30 minutes to 1 hour long |
| Recovery Duration | Daily activities resumed within 24-48 hours; demanding activities should be avoided for 1 to 2 weeks, and complete recovery is within 2 to 4 weeks. |
Laser Varicose Vein Treatment: Pre-Op & Post-Op Care
Laser varicose veins is conducted in three different phases to ensure a safe, accurate, and smooth experience. The process starts with preparation before the procedure, continues with the laser treatment, and ends with a guided recovery period.
Understanding these phases helps patient to know exactly what to expect at every step.
Laser varicose vein treatment – pre-operative phase
A complete pre-operative examination ensures that treatment is safe, accurate, and successful.
Initial clinical examination includes a vascular specialist performing a focused evaluation of both legs to recognise the veins that are causing issues. Symptoms include heaviness, swelling, throbbing, cramps, and darkening of skin, which are evaluated to determine severity.
A high-resolution duplex ultrasound scan is done to map the affected venous system. This scan examines valve incompetence, reflux duration, and the diameter and course of the saphenous vein.
Mopping by using ultrasound helps in the selection of appropriate access points for the laser fibre.
The health professional then examines diseases like diabetes, hypertension, cardiovascular diseases, clotting disorders, or previous deep vein thrombosis incidence. Any history of allergies, especially to local anesthesia or medicines, is reviewed.
Patients using anticoagulants are advised to temporarily make adjustments to dosage based on clinical judgement. Painkillers and the use of anti-inflammatories can be stopped for a few days before beginning the procedure.
Patients are then advised to stop using creams, moisturizers, and oils on the legs on the day of treatment. A light meal is then permitted for the patient a few hours before the start of surgery, as it is done under the influence of local anesthesia.
Class 2 compression stockings are suggested by physicians beforehand, so they can be used by patients immediately after completion of laser varicose vein treatment.
Just before going into the room where surgery is to be done, the surgeon marks the skin using an ultrasound. This marking ensures accuracy in guiding the laser catheter.
During the laser varicose vein surgery
Laser varicose vein treatment, which is Endovenous laser ablation (EVLA) or Endovenous laser treatment, is a minimally invasive technique, and the procedure is completed within 30-60 minutes.
The patient lies on the procedure table, usually on their back with their face facing upward. The leg is then cleaned using an anti-septic solution, and sterile drapes are then placed.
Under real-time ultrasound guidance, the physician introduces a thin needle into the affected vein, a guidewire is then passed through the needle, and a small introducer sheath is placed to allow the entry of the laser fibre.
The laser fibre is then advanced through the sheath into the vein, under the guidance, to a point near the groin or knee where the reflux starts.
Placement is confirmed with ultrasound to make sure it is positioned in its indeed place away from the pathway to a major organ.
A diluted solution of local anesthesia is injected around the vein by using multiple tiny injections along the length of the vein. This is for protecting the surrounding tissues from laser heat, collapsing the varicosed vein around the fibre, and providing pain control.
After placing it appropriately, the laser generator is turned on, and the surgeon then slowly withdraws the laser fibre while delivering controlled laser energy. This causes the varicosed vein walls to seal themselves. Throughout the process, ultrasound imaging guarantees accuracy and safety.
The fibre and the sheath are removed once the target vein is sealed, small bandages are applied over the points of entry, and patients are advised to wear the compression stockings immediately.
After the laser varicose vein procedure
After the laser varicose vein treatment, recovery is generally fast because the surgery is minimally invasive.
Immediately after the surgery, patients are asked to rest in the clinic for 15-30 minutes. Important signs are observed, and confirm that there are no extra cuts or discomfort.
Patient is asked to walk a few minutes after surgery is completed to allow proper blood circulation, increase the blood flow to the site, and decrease the risk of deep vein thrombosis. Patients can also start their day-to-day activities within a few hours.
Compression stockings must be worn continuously for 24-48 hours, after that, during the daytime for 1-2 weeks. This compression helps in vein closure, decreases swelling, and promotes healing.
Mild soreness, tightness, or pulling sensations along the treated vein are increasingly common and temporary. Over-the-counter painkillers are usually recommended for comfort. Bruising is mild and typically resolves within 1-2 weeks.
A follow-up duplex ultrasonography scan is scheduled after 1 week to confirm that the treated vein has closed successfully. Additional treatments are planned if necessary.
Final cosmetic and symptomatic improvement continues over weeks to months. The closed vein is gradually absorbed by the body and does not show any signs of a problem.
Benefits of Laser Varicose Vein Treatment at Yashoda Hospitals
- Minimally invasive
- Less pain
- Safe and effective
- Decreased risk of complications
- Fast recovery
- Outpatient technique
- Improved appearance
- Long-lasting relief
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