What are Varicose Veins?
Varicose veins, also known as varicoses or varicosities, occur when your veins become enlarged, dilated, and overfilled with blood. Varicose veins typically appear swollen and raised, and have a bluish-purple or red color. They are often painful.
The condition is very common, especially in women. Around 25 percent of all adults have varicose veins. In most cases, varicose veins appear on the lower legs.
What is endovenous laser varicose vein surgery?
Endovenous laser varicose vein surgery is a procedure that uses heat from a laser to reduce varicose veins. Varicose veins are swollen, bulging veins that often happen on the thighs or calves. A laser is a device that sends a thin beam of radiation in the form of light.
Laser surgery closes and shrinks the varicose vein and causes scar tissue within the vessel. This seals off the vein. Blood then flows through other nearby veins instead.
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Before Endovenous Laser Treatment for Varicose Veins
Symptoms of Varicose Veins
In the majority of cases, there is no pain, but signs and symptoms of varicose veins may include:
. Veins look twisted, swollen, and lumpy (bulging)
. The veins are blue or dark purple
Some patients may also experience:
. Aching legs
. Legs feel heavy, especially after exercise or at night
. A minor injury to the affected area may result in longer bleeding than normal
. Lipodermatosclerosis – fat under the skin just above the ankle can become hard, resulting in the skin shrinking.
. Swollen ankles
. Telangiectasia in the affected leg (spider veins)
. There may be a shiny skin discoloration near the varicose veins, usually brownish or blue in color.
. Venous eczema (stasis dermatitis) – skin in the affected area is red, dry, and itchy.
. When suddenly standing up, some individuals experience leg cramps.
. A high percentage of people with varicose veins also have restless legs syndrome.
. Atrophie Blanche – irregular whitish patches that look like scars appear at the ankles.
When to see a doctor
Self-care — such as exercise, elevating your legs or wearing compression stockings — can help you ease the pain of varicose veins and may prevent them from getting worse. But if you're concerned about how your veins look and feel and self-care measures haven't stopped your condition from getting worse, see your doctor.
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Causes of Varicose Veins
The veins have one-way valves so that the blood can travel in only one direction. If the walls of the vein become stretched and less flexible (elastic), the valves may get weaker. A weakened valve can allow blood to leak backward and eventually flow in the opposite direction. When this occurs, blood can accumulate in the vein(s), which then become enlarged and swollen.
The veins furthest from the heart are most often affected, such as those in the legs. This is because gravity makes it harder for blood to flow back to the heart. Any condition that puts pressure on the abdomen has the potential to cause varicose veins; for instance, pregnancy, constipation and, in rare cases, tumors.
Experts are not sure why the walls of veins stretch or why the valves become faulty. In many cases, it occurs for no clear reason. However, some potential risk factors include:
. Being aged over 50
. Standing for long periods
. Family history of varicose veins
The following risk factors are linked to a higher risk of having varicose veins:
. Gender: Varicose veins affect women more often than males. It may be that female hormones relax veins. If so, taking birth control pills or hormone therapy (HT) might contribute.
. Genetics: Varicose veins often run in families.
. Obesity: Being overweight or obese increases the risk of varicose veins.
. Age: The risk increases with age, due to wear and tear on vein valves.
. Some jobs: An individual who has to spend a long time standing at work may have a higher chance of varicose veins.
A physical examination, mainly visual, by a doctor will decide whether or not a patient has varicose veins. The patient will be asked to stand while the doctor checks for signs of swelling.
The following diagnostic tests are sometimes ordered:
. Doppler test: An ultrasound scan to check the direction of blood flow in the veins. This test also checks for blood clots or obstructions in the veins.
. Color duplex ultrasound scan: This provides color images of the structure of veins, which helps the doctor identify any abnormalities. It can also measure the speed of blood flow.
The patient may also be asked questions about the symptoms. In some cases, a doctor might refer the patient to a vascular specialist.
Why might I need endovenous laser varicose vein surgery?
Your healthcare provider may suggest laser surgery if your varicose veins are sore, or red and swollen (inflamed). Laser surgery may also be recommended if the skin over your varicose veins is irritated.
Varicose veins are not usually a serious health problem, but they can be painful. You may also not like how they look.
How do I get ready for endovenous laser varicose vein surgery?
. Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
. You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
. Your healthcare provider will ask questions about your health history. He or she may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests.
. Tell your healthcare provider if you have a history of bleeding disorders. Let your healthcare provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.
. Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, tape, contrast dyes, and anesthesia medicines (local and general).
. Tell your healthcare provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.
. You must not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight.
. You may have medicine to help you relax (sedative).
. Arrange to have someone to drive you home after the procedure.
. Your healthcare provider may have other instructions for you.
The key benefits of endovenous laser therapy
Endovenous laser therapy is a quick, minimally invasive laser procedure that leaves no scar, has a short and relatively pain-free post-operative recovery period, and may be performed under local or general anaesthesia. The treatment itself will take less than one hour. You should be able to resume normal activities within 1-2 days.
Patients report minimal to no scarring, bruising or swelling following the procedure.
What are the risks of endovenous laser varicose vein surgery?
All surgeries have some risks. Some possible risks of laser varicose vein surgery include:
. Pain over the vein
. Nerve damage
. Redness or swelling (inflammation) of the vein
. Blood clots
. Changes in skin color over the treated vein
You may have other risks, depending on your general health. Be sure to talk with your healthcare provider about any concerns you have before your surgery.
During Endovenous Laser Treatment for Varicose Veins
What happens during endovenous laser varicose vein surgery?
This procedure doesn’t require a hospital stay. It may be done in your healthcare provider’s office. The procedure usually takes less than an hour. You can likely go home the same day. Bring loose-fitting clothing to wear right after your surgery.
Generally, endovenous laser varicose vein surgery follows this process:
. You’ll change into a hospital gown and lie down on an exam table. The table may be tilted in different positions during the procedure. You may be given special goggles or eyeglasses to wear during the surgery. This is to protect your eyes from the laser light.
. Your healthcare provider will numb the area where the tube or catheter will be put into your vein. Your healthcare provider will also give you a shot or injection of numbing medicine along the length of the vein that will be treated.
. Your healthcare provider will use a Doppler ultrasound device to check the vein before and during the procedure. This process uses sound waves to make an image of the vein on a computer screen.
. Your healthcare provider will make a small cut or incision in your skin and insert the catheter. It will be guided into the varicose vein. A laser fiber will be put into the catheter. As your healthcare provider slowly pulls out the catheter, the laser will heat up the length of the vein. The vein will close up and should eventually shrink.
The procedure usually takes less than an hour. The cut where the catheter was inserted will likely be small enough that you won’t need stitches. A bandage will be put on the site.
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After Endovenous Laser Treatment for Varicose Veins
What happens after endovenous laser varicose vein surgery?
. You will be encouraged to walk right after the procedure, for about 30 to 60 minutes.
. Your leg may have some bruising. The bruises should go away in about 2 weeks.
. You’ll need to have someone drive you home after your surgery.
After you go home, be sure to follow any instructions from your provider. You may be told to:
. Put an ice pack over the area for 15 minutes at a time, to help reduce swelling.
. Check the incision sites every day. It’s normal to see light pink fluid on the bandage.
. Keep the incision sites out of water for 48 hours. You may need to take a sponge bath until the bandages are removed.
. Wear compression stockings for a few days or weeks, if advised. These stockings gently squeeze your legs. This helps to prevent swelling in your legs. It can also help stop your blood from clotting or pooling.
. Not sit or lie down for long periods of time. Keep your leg raised when sitting.
. Not stand for long periods of time.
. Walk about 3 times a day for 10 to 20 minutes each time. Do this for 1 to 2 weeks.
. Keep active, but don’t run, jump, or lift heavy things for 1 to 2 weeks.
. Not take hot baths for 1 to 2 weeks.
When it comes to medicine, be sure to:
. Take over-the-counter pain medicine as needed, and only if advised by your healthcare provider. Some medicines can increase bleeding.
. Ask your healthcare provider when it will be safe to take blood-thinning medicine again, if you stopped taking it for the surgery
. Your healthcare provider may want to give you an exam at a follow-up visit. He or she may use ultrasound to make sure the laser procedure worked.
Call your healthcare provider if you have:
. Signs of infection in the treated area. These include redness, warmth, or fluid leaking from the incision.
. Swelling that gets worse, or new swelling
. Any pain that keeps you from doing your normal activities
Your healthcare provider may give you other instructions, depending on your situation.