Patients with varicose veins have a variety of choices ahead of them. One, they can choose to do nothing about their bulging veins – but then they run the risk of the veins growing worse. Two, they can try to improve the veins at home with over the counter compression stockings and lifestyle changes. Or, for those seeking expert care, they can get in touch with a vascular professional to learn more about their treatment options.
When considering which varicose vein treatment is “best” for you, there are many different factors at play. The first thing to consider is that “best” is misleading – there is no one treatment that is universally recommended for varicose veins. Rather, your symptoms, your veins and your personal preferences dictate which treatment will be ideal.
That said, it is beneficial to learn more about the treatment options available before you meet with a doctor. The landscape of vein treatments is changing, and new technologies are making a different patient experience possible. Read on to learn more, and schedule a consultation with our cardiovascular surgeon, Dr. Muasher, to gain personalized guidance and care.
Common Varicose Vein Treatment Options
Varicose veins are vessels with malfunctioning valves. The valves within these veins are supposed to guide the blood in a healthy direction, helping it flow back towards the heart and lungs to be replenished with and then recirculated. But these valves can leak, allowing some blood to flow backwards and pool in the veins. The veins then become enlarged and may become twisted.
Varicose veins most commonly occur in the legs because the blood has further to travel and leg muscles may not provide enough pumping to keep the blood flowing, especially if the individual does not get much activity.
Varicose vein treatments aim to close off the problematic veins to divert blood through healthier veins. Closing the problematic veins will not have an adverse effect on your health or overall circulation, and can help you avoid more serious concerns in the future.
While all treatments aim to close the problem veins, they do so through different approaches.
It’s also important to mention compression therapy, which does not close varicose veins, but helps stimulate healthy blood flow. Compression therapy is completed at home using over the counter or prescription compression garments like stockings.
Other treatment options include:
- Sclerotherapy – Injection of a sclerosant into the varicose vein, which irritates the lining and causes it to close
- EVLT (Endovenous laser therapy) – Use of laser energy to seal off a varicose vein
- Stripping and ligation – Surgical removal of the varicose vein
Which Treatment Offers the Best Results?
As we mentioned, the best treatment is one that suits your needs. But there is research that suggests that laser therapy may have an advantage.
A study that ran from 2008-2012 investigated vein treatments received by 798 participants at vascular surgery centers in the United Kingdom. This study was published in the New England Journal of Medicine. Participants either received EVLT, sclerotherapy or surgical vein removal. Researchers measured the outcomes at six months out from treatment.
Measuring how well the treatment worked, complication rates, and how the participants rated the positive change in their quality of life led to the study concluding that laser therapy was the best-performing treatment.
Laser therapy was preferred by the participants, and also offered fewer post-treatment complications. Just 1% of patients who received laser treatment experienced complications, whereas 6% of those who received sclerotherapy and 7% of those who underwent surgery saw effects like lumpiness, stained skin or numbness.
Foam treatment was less likely than the other treatment options to completely close a vein with leaky valves. This means that retreatment could be necessary in the future.
The study also found that laser treatment and surgery were more effective at treating the great saphenous vein that sclerotherapy. This is the longest vein in the body, which runs along the leg. The success rates for foam sclerotherapy decrease as vein sizes increase.
These numbers considered, surgery may still be the best treatment for patients who fall into certain categories, including:
- Having previously had vein procedures
- Having anatomical abnormalities, like veins being especially close to the skin or larger than ¾ inch in diameter
The research team will continue following study participants for five years to learn more about the long-term results of treatment.
Wondering which of these treatments might be ideal for your varicose veins? Schedule a venous assessment to meet with Dr. Muasher and receive expert answers to your questions, as well as undergo a study of your veins.
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