Emory Report
February 14, 2005
Volume 57, Number 19


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February 14, 2005
Outpatient laser treatment can zap varicose veins

BY Janet Christenbury

Pain and discomfort are just two of the common complaints of having varicose veins; many describe their unattractive legs as the condition’s biggest downside. Now a new laser procedure at Emory can remove those painful and ugly veins without surgery.

Varicose veins result from the reflux of blood down the legs from non-functioning valves. Normally, one-way valves allow that blood to flow upward, but when the valves become weak and stop closing properly, the blood begins to flow in the wrong direction. The increased pressure from reflux causes blood to pool and triggers the bulging and twisting condition known as varicose veins.

Varicose veins affect half the population age 50 and above, and 15–25 percent of all adults. Often they are inherited, and they’re also commonly caused by obesity and pregnancy. Both men and women develop varicose veins, but it is more common in women. Surgical “vein stripping” (an inpatient procedure usually requiring general anesthesia and a long recovery, not to mention significant pain and bruising) has been the most common method of removing them—until now.

“This new, minimally invasive procedure using a laser is the newest wave in varicose vein treatment,” said Abbas Chamsuddin, associate professor of radiology and director of interventional radiology. “It’s a 45-minute outpatient procedure that involves no anesthesia, no scarring and minimal pain. And patients can quickly return to normal activities following treatment.”

Chamsuddin and his colleagues have performed more than 300 laser treatments for varicose veins at Emory. The treatment works by inserting through a small incision a catheter into the one of the saphenous veins in the leg. (The large saphenous vein runs from the groin to the ankle, and the small saphenous vein runs from the ankle to the knee along the back of the leg.) To minimize pain and reduce blood loss and bruising, a local anesthetic and epinephrine (a drug used to contract blood vessels) are injected into the leg around the site of the catheter.

Using an ultrasound machine as a guide, a laser fiber is threaded up into the vein. The laser, a highly
concentrated beam of light, is emitted through the fiber, destroying the varicose vein. Because the vein’s blood flow instantly shuts down, the body automatically reroutes the blood to other, healthy veins. The faulty vein does not have to be removed from the body. Results can be seen in several days to several months.

No surrounding tissue is affected since the laser delivers light energy precisely to the targeted vein. Following the procedure, patients must walk for 30 minutes to prevent blood clotting, and they must wear compression hose for a week. Follow-up treatments may be necessary to obtain optimal aesthetic results.

“Laser treatments have proven to be 97 percent effective in clinical trials,” Chamsuddin said. “Patients should not experience any reoccurrence in the veins once treated.”

Most major insurance companies and Medicare cover the laser treatment. For more information on the procedure or to schedule an appointment, call the Emory Health Connection at 404-778-7777.