Varicose veins are blood-filled twisted, enlarged, and painful veins. They usually appear on the legs and rise above the skin's surface. They are not life-threatening, but they can be uncomfortable.
To remove varicose veins, a procedure known as "vein stripping" was traditionally used. Small incisions are made and the veins are physically pulled out of the body.
Recent technologies, on the other hand, use minimal or noninvasive procedures to remove varicose veins. A noninvasive procedure is not surgical and does not use tools or equipment that cut the skin or physically enter the body. Tiny incisions in the skin are used to perform minimally invasive procedures.
Noninvasive treatments for varicose veins
There are several minimally invasive or noninvasive procedures for treating varicose veins. Here are some examples:
Sclerotherapy
Sclerotherapy aims to destroy varicose veins by injecting them with a sclerosant solution. The sclerosant scars and collapses the vein, forcing blood to reroute to healthier veins.
The veins are eventually destroyed by your body and disappear over time. Sodium tetradecyl sulfate is a common sclerosant solution. This procedure is typically used to treat small varicose veins near the skin's surface, known as "spider veins," to improve the appearance of the leg.
Foam sclerotherapy involves converting the sclerosant into foam before injecting it into the vein. Because foam can cover a larger surface area than liquid, it is used for larger veins.
Radiofrequency ablation
Radio waves, also known as radiofrequency energy, are transmitted through the vein wall during this procedure. Your doctor will numb the vein, then use an ultrasound to see inside the leg before passing a wire catheter along the vein to apply radiofrequency energy to its wall.
The vein wall will heat up, thicken, and contract before being reabsorbed by the body and disappearing. The full effects of this procedure may take several weeks or months to become apparent.
Endovenous laser ablation
Laser ablation is similar to radiofrequency ablation, with the exception that laser energy is used instead of radiofrequency energy.
The laser fiber is inserted into the catheter and moved to the desired location, and the laser energy causes the vessel to close due to heat. Over time, the vein will shrink and be reabsorbed by your body. Deeper veins in the leg are frequently treated with radiofrequency and laser therapy.
Phlebectomy
Another minimally invasive procedure for varicose veins treatment is phlebectomy. The doctor makes a small incision near the vein and uses a special hook to remove the vein through the incision.
You will be awake during this outpatient procedure because it is performed with a local anesthetic. It usually takes between 30 and 60 minutes to finish. Some people may require a repeat procedure to achieve the best results.
What can you expect during a noninvasive treatment for varicose veins?
Noninvasive varicose vein treatment is usually done in a doctor's office with a local anesthetic.
Before the procedure
If you are pregnant, have any allergies, or are taking any medications, including herbal supplements, inform your doctor. A few days before the procedure, your doctor may ask you to stop taking aspirin, blood thinners, or any other medications that make it difficult for the blood to clot.
During the procedure
You will be awake throughout the procedure. Your doctor will use ultrasound to visualize the vein and a local anesthetic to clean and numb your leg.
When the catheter is inserted, you may feel slight pressure or stinging if a sclerosant solution is injected into the vein. If lasers are used, you must wear protective glasses during the procedure. Closing the vein with radiofrequency or laser should not be painful.
After the procedure
Bandages may be applied to your legs to control swelling and bleeding. These bandages may need to be worn for several days.
You should arrange for someone to drive you home after the procedure, and you should avoid strenuous exercise for a week or two afterward. Acetaminophen (Tylenol) may be prescribed for pain, but avoid any pain relievers that may interfere with blood clotting, such as aspirin or ibuprofen.
In addition, your doctor may advise you to avoid hot baths or whirlpools after the procedure. Showers or sponge baths with mild soap and warm water are advised.