Endovenous Laser Treatment

The new kid on the block

Approved by the FDA in January 2002, the endovenous laser treatment is a fairly new way to remove varicose veins. It consists of heating the inside of a vein with laser energy. A small fiber is inserted inside the vein and laser energy is applied directly to the vein wall. The temperature at the fiber tip can exceed 1000°C. This heat causes a thermal injury sufficient to close the vein. The vein then disappears by being eliminated by the body healing process.

One major difficulty with endovenous laser treatment is to limit the injury to the vein. With that much heat, you don’t want the surrounding muscles, nerves and skin to be burned. The solution is to inject an anesthetic solution that completely surround and compress the vein. For that reason, no general anesthesia is necessary.

The advantages and restriction of endovenous laser treatment

The laser fiber is inserted close to the knee. This means a lower risk of complications after the intervention compare to surgery because there is no cut at the groin. This treatment has a 98.1% success rate when it comes to eliminate the treated vein, which is very similar to conventional stripping. In fact, a recent large study concluded there was “no significant difference” between laser ablation and conventional stripping success at treating varicose veins. [1]

For the physician to accept laser treatment, the vein has to be relatively straight. Veins that are extremely tortuous will not allow passage of the laser fiber.

Watch the video below to assist a laser treatment procedure, also called “laser ablation”, from beginning to end.

Is laser ablation really “pain free”?

Unfortunately, some treatment centers specializing in varicose veins have been caught by the Federal Trade Commission making unfair promises to patients. Notice how today their advertisements always say “Virtually pain free.” That’s marketing talk for “It’s not really pain free, but I don’t want to tell you.”

In fact, one study had 20 patients received laser treatment on one leg and conventional stripping on the other. According the patients, postoperative pain was the same in both treatment. [2]

What is the cost of endovenous laser treatment for varicose veins?

Endovenous laser ablation is about 3 times more expensive than sclerotherapy. But patients report less need for a second treatment. The average cost of endovenous laser ablation in the US is $1142.96 [3]

With that much money involved, a lot of doctors are pushing for laser ablation when it is not necessary. [4] If you go see a doctor for little spider veins on the leg and the doctor says you need ablation, you should seek a second opinion.

One “loophole” is being used onto people who pay for endovenous laser treatment. Your vein specialist may make you agree that a successful treatment is when your varicose veins is closed. But closed veins can always reopen. Make sure that your varicose vein completely disappears in the weeks following your treatment. Not knowing this fact could double your risks of having your varicose vein literally come back. Make sure both you and your phlebologist agree on the terms of a successful treatment.

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Marc Livingston

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