When treating varicose veins, laser therapy remains the best option, says a new study.
Researchers in the study looked at 798 participants who had varicose veins and were treated at 11 vascular surgery centers in the United Kingdom between November 2008 and October 2012. Participants underwent one of three types of treatment: closing the veins with a laser, injecting a drug ” “foam” in the vein or surgical removal of the vein.
After six months, the researchers compared the results, looking at how well the treatments worked and their complication rates, as well as how the participants rated the change in their quality of life from their treatments.
“The main findings showed that laser therapy was the preferred treatment for varicose veins,” said study author Dr. Julie Brittenden, professor of vascular surgery at the University of Aberdeen in Scotland. “We found that all three treatments reduced symptoms associated with varicose veins, but there were fewer complications after laser treatment.” [7 Beauty Trends That Are Bad for Your Health]
What causes varicose veins?
Varicose veins are blood vessels that have become swollen, enlarged and twisted. Malfunctioning valves in the veins cause the disorder, Brittenden explained. In people with this condition, blood returns to the heart from the veins in the legs because of the contraction of the calf muscles, he said. Normally, the valves in these veins prevent blood from flowing backwards, down into the legs.
“People with varicose veins have leaky valves, which means some blood flows backwards and pools in the veins, causing them to enlarge,” he said.
The procedure, called intravenous laser ablation or laser therapy, uses heat generated by laser energy to seal off the faulty blood vessels, diverting blood flow immediately to nearby healthy veins.
Foam therapy involves injecting medication into a blood vessel. The drugs, when mixed with air, cause the vessel wall to thicken, which also helps seal off blood flow. The recent study showed that the foam was less likely than other treatments to completely close a vein that had leaky valves, which can increase the chance that a patient will need future treatment, Brittenden said.
In the study, about 1 percent of patients treated with the laser experienced complications such as swelling, skin spots and numbness. About 6 percent of those who received the foam treatment and 7 percent of those who underwent surgery experienced such complications, according to the study.
The researchers also found that successful removal of the great saphenous vein occurred in 83 percent of those who received the laser treatment and in 84.4 percent of the participants who underwent surgery. These numbers were significantly higher than the 54.6 percent that had such successful removal after foam treatment. The great saphenous vein, the largest in the body, runs along the leg.
The study is published in today’s (September 24) issue of the New England Journal of Medicine.
Dr. Kevin McMullen, a vascular surgeon at Surgical Hospital of Oklahoma who was not involved in the study, said he agreed with Brittenden’s conclusion. “Laser is preferred over surgery or foam because of higher success rates with fewer complications,” he said.
Laser therapy works better than foam on larger veins, as success rates for foam treatments get worse as the size of the vein increases, McMullen said. However, surgery may be the best option for patients who have previously undergone vein procedures or who have anatomical problems, such as veins that are too close to the skin or are larger than three-quarters of an inch (20 millimeters) in diameter, he said.
Can varicose veins be prevented?
Varicose vein treatment isn’t just for cosmetic reasons, Brittenden said. “People with varicose veins often suffer from pain and discomfort,” he told Live Science. “The condition can also cause swelling of the ankles, skin changes and sometimes ulcers.”
Both men and women get varicose veins, he said. The condition is more common in pregnant women, elderly patients, overweight people and those who stand for long periods. It is also more common in people who have a family history of varicose veins.
People can’t prevent varicose veins from forming, but they may be able to delay their formation or prevent existing varicose veins from getting worse, according to the National Institutes of Health. The NIH recommends that people avoid standing or sitting for long periods of time without taking breaks. avoid crossing their legs when sitting. and keep their legs elevated when sitting, resting or sleeping.
Losing weight and exercising that works the leg muscles can also help, the NIH said.
Brittenden said she and her team plan to follow study participants for five years, as long-term results are important to determine the long-term costs and consequences of each of the treatments, such as recurrent varicose veins.
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