Laser Treats Varicose Veins Non-Surgically; Study Results Show Long-Term Efficacy for Minimally Invasive Interventional Radiology Treatment

SALT LAKE CITY, Utah -- A new study shows that the minimally-invasive laser treatment of varicose veins has a high long-term success rate, low complication rate and rapid recovery, according to data presented here today at the 28th Annual Scientific Meeting of the Society of Interventional Radiology.

"The laser treatment is an outpatient procedure that offers many benefits including little to no pain, no general anesthesia, no scars, less cost, and rapid recovery time compared to traditional surgery," says Dr. Robert J. Min, M., director of Cornell Vascular, and assistant professor of radiology at Weill Medical College of Cornell University, New York. "The procedure takes less than an hour and people can return to normal daily activity immediately, says Min, an interventional radiologist who helped develop the EndoVenous Laser Treatment (EVLT).

Varicose veins are a common condition, affecting one in two people age 50 or older, and about 15 percent of men and 25 percent of women overall. Risk factors include age, family history, female gender and pregnancy. Symptoms caused by varicose veins include aching pain, easy leg fatigue, and leg heaviness, all of which worsen as the day progresses. Many people find they need to sit down in the afternoon and elevate their legs to relieve these symptoms.

Varicose veins are a symptom of venous insufficiency with pooling of blood in the veins. Normally, stop valves in the vein close to keep blood from flowing downward with gravity. When the valves in the vein become weak and don't close properly, they allow blood to flow backward, or reflux. Varicose veins are prominent veins that have lost their valve effectiveness and, as a result of dilation under pressure, become elongated, rope-like, bulged, and thickened.

A common cause of varicose veins is reflux within the greater saphenous vein in the thigh, which leads to pooling in the visible varicose veins below. By closing the greater saphenous vein, the varicose branch veins below shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.

This minimally invasive treatment is an outpatient procedure performed using duplex ultrasound imaging guidance. After applying local anesthetic to the vein, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the vein and guides it up the greater saphenous vein in the thigh. Then laser energy is applied to the inside of the vein. This heats the vein and seals the vein closed. There may be minor soreness or bruising, which can be treated with over-the counter pain relievers. There is no scar, because the procedure does not require a surgical incision, just a nick in the skin, about the size of a pencil tip.

The Cornell study included 499 limbs with varicose veins treated over a three-year period with diode laser energy. Patients were evaluated clinically and with duplex ultrasound at one week, one month, six months, 12 months and 24 months to assess efficacy and adverse reactions. Two-year follow-up results in 121 limbs showed that 93 percent, (113 of the 121) of the treated veins have remained closed. All recurrences have occurred prior to nine months, with the majority noted less than three months following endovenous laser. There have been no skin burns, no abnormal nerve sensation and no deep vein clots.

By comparison, surgical ligation or vein stripping fails more often, and requires general anesthesia and up to two weeks of recovery. Pain, bruising and scarring are common. "Even when you remove the vein with surgery, there is a 10 to 25 percent chance of recurrence. We have a less than 7 percent recurrence rate for a much less invasive procedure," says Min.

The treatment costs about $2,000 to $3,000; surgery typically costs three times that amount. Many insurance companies cover the treatment of varicose veins, because it is not just a cosmetic procedure. Varicose veins indicate venous insufficiency, which is a medical condition that causes symptoms for many people.

Cornell Vascular is one of a rapidly growing number of centers offering this relatively new, FDA approved, minimally invasive treatment of varicose veins. There are about a dozen sites in the United States and many more physicians are now being trained in the technique.

An estimated 5,000 people are attending the Society of Interventional Radiology 28th Annual Scientific Meeting in Salt Lake City. The Society represents interventional radiologists -- physicians who specialize in minimally invasive, targeted treatments performed using guided imaging. Interventional radiology procedures are a major advance in medicine that do not require large incisions -- only a nick in the skin about the size of a pencil tip -- and offer less risk, less pain and shorter recovery times compared to surgery. Interventional radiologists pioneered modern medicine with the invention of angioplasty, the first catheter-delivered stent and the coronary angiography technique most used worldwide -- state of the art treatments that are commonplace in medicine today.

Source: Society of Interventional Radiology