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Lasers have been
used for numerous medical applications throughout the body.
Recently, a novel technique utilizing laser energy delivered
endovenously (directly inside the vein) has been developed to
treat varicose veins. An 810 nm diode laser will be used to
deliver the laser energy via a small laser fiber. Endovenous
laser treatment is performed under local anesthesia in the
doctor's office. There is little to no scarring and a
relatively short recovery period after the procedure.
Procedure
At your first visit, the doctor will interview you and take a
medical history and examine your legs. Duplex ultrasound
imaging (a machine which allows the doctor to visualize the
blood vessels and record their size and shape) will be
scheduled if necessary. Photographs of the treatment areas
will be taken.
During the
procedure, you will be given special eye goggles to protect
your eyes against accidental exposure to laser light. Next,
the treatment area will be anesthetized with lidocaine. A
sterile laser fiber will be inserted into the vein and
positioned under ultrasound guidance. Laser energy will be
delivered to selectively treat the target vein. A compression
stocking will be applied and must be worn for at least one
week following treatment.
You will return to
the office within one week and the doctor will examine the
treated vein. Doppler and duplex ultrasound evaluation will be
done and additional photos may be taken.
Repeat
endovascular laser treatment using modified parameters may
need to be done at the discretion of the doctor.
Risks and
Discomforts
Results after EndoVenous Laser Treatment have been
excellent. It is important to remember that each patient's
results may vary; your symptoms of varicose veins may improve,
remain the same, or worsen.
The potential side
effects are thermal injury (burn) to the overlying skin or
intervening tissue, perforation of the vein, breakage of the
laser fiber, superficial phlebitis (inflammation of the vein),
hyperpigmentation (darkening of the overlying skin), or
neovascularization (growth of new veins). DVT, PE, and even
death have never been reported with EndoVenous Laser
Treatment, however, these things have been reported with every
other treatment of varicose veins (surgery and sclerotherapy)
therefore, must be considered a possibility. Problems and side
effects that are not know at this time could occur.
For most people,
needle punctures into the vein do not cause any serious
problems. However, they may cause dizziness, minimal bleeding,
bruising, discomfort, pain, and rarely infection. Local
anesthesia will be used to minimize discomfort. Rarely, people
can have an allergy to Lidocaine.
Potential
Complications of not Undergoing Treatment
The potential complications of not undergoing treatment
are often to merely a worsening of the condition, i.e. an
increase in the number of veins or enlargement in the existing
veins. In case of large varicose veins, spontaneous
superficial phlebitis or bleeding may occur. Patients with
varicose veins associated with underlying venous insufficiency
may develop ankle swelling and/or skin changes (eczema,
hyperpigmentation, ulceration).
Alternative
Treatments
Since varicose veins and spider veins are not life
threatening. Treatment is not mandatory. Some patients may get
adequate symptomatic relief by wearing graduated compression
stockings. Alternative treatments for varicose veins include
surgical ligation and stripping, ambulatory phlebectomy,
ultrasound-guided sclerotherapy, bipolar radiofrequency (heat
destruction), or combination of these treatments.
Potential
Benefits
The potential benefits of the procedure are reduction in
the size or closure of the treated varicose veins and
improvement in varicose vein-related symptoms. Results to
date, although early, have been very promising with
essentially no recurrence and good cosmetic appearance. It is
also possible that your condition may remain the same or
worsen.
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