Laser Treatment of Leg Veins - Types, Preparation, Procedure, and Prognosis

Introduction:

Varicose or spider veins are twisted and enlarged veins that become prominent in the legs when a person stands or walks for prolonged periods. This is because walking or standing increases pressure on the veins in the lower body. As a result, the patient might experience pain and discomfort. Sometimes these veins can cause severe complications. They also affect the appearance of the legs and can cause open sores or blood clots. Several minimally invasive surgical procedures help eliminate these veins to prevent pain, fatigue, and other complications. Laser treatment is one of the ways to make these varicose veins disappear by using a high-energy beam of light.

What Is Laser Treatment for Varicose Veins?

Laser (light amplification by stimulated emission of radiation) treatment has become a popular choice among people with visible leg veins because of its excellent results. The treatment should aim to reduce the pressure associated with varicose veins. However, if the patient continues to experience pressure, the treatment can be considered a failure. Some patients benefit from a combination of treatment modalities, including sclerotherapy or phlebectomy. The most significant drawback of laser treatment is that it does not effectively treat all the reticular and varicose veins. Lasers are explicitly used to treat veins less than 0.03 inches in diameter and are resistant to sclerotherapy or other procedures. However, with developments in medical science and the advent of the high-pulsed laser, the treatment outcomes have improved and become favorable.

What Factors Determine the Treatment Procedure for Leg Veins?

There are several procedures available that treat the visible leg veins. However, not all procedures are suitable for the patient. Hence the choice of procedure is influenced by the following factors:

• Patient's age.

• Overall health.

• The extent of the varicose veins.

• Associated symptoms.

• Patient's goals and expectations.

What Are the Different Types of Laser Treatment?

Laser treatment is commonly used to treat visible leg veins using heat. As a result, scar tissue forms resulting in the closure of the leg veins. When the veins get closed, it does not receive blood supply and dies. This vein usually disappears after one or two years. The different types of laser treatments are listed below:

1. Simple Laser Treatment - It is a procedure done on the external surface of the skin. This procedure aims to treat spider veins or varicose present beneath the skin. However, this procedure usually requires multiple laser sessions that are scheduled at an interval of six to 12 weeks.

2. Endovenous Laser Treatment - This procedure uses heat to treat the large varicose veins in the legs. The doctor inserts a thin tube or a catheter into the vein during the procedure. Finally, the doctor observes the images on the duplex ultrasound screen.

How Should the Patient Prepare for an Endovenous Laser Treatment Procedure?

• The procedure is simple, painless, and minimally invasive. Hence the patient must understand it carefully and discuss the outcomes with the doctor.

• Finally, when the patient has understood the procedure, the patient will be required to sign a consent form that states that the patient is willing for laser treatment.

• Before initiating the procedure, the doctor will ask about the patient's medical history and conduct a physical examination. This is done to ensure that the patient is medically fit for the procedure and will not develop complications.

• Next, the patient will be asked to undergo the required laboratory tests, including blood or urine tests.

• The patient needs to inform the doctor if he has experienced bleeding disorders or is taking any blood thinner, including Aspirin or over-the-counter drugs like Ibuprofen.

• The patient should inform the doctor if he develops any allergic reactions to latex, contrast medium, tapes, or anesthetic solutions.

• Do not eat or drink anything eight to 12 hours before the surgery.

What Happens During the Endovenous Laser Procedure?

Endovenous laser surgery is a simple procedure and staying in the hospital for prolonged periods is not required. The procedure gets completed in an hour, and the patient can go home the same day. The steps of the endovenous laser procedure are listed below:

• First, the patient will be asked to change into a hospital gown.

• Next, the doctor instructs the patient to lie down on the table. The doctor might tilt the table at different angulations during the procedure. In addition, the patient might be given glasses before the surgery so that the eyes do not get damaged due to the laser light.

• The doctor will anesthetize the area where the catheter is to be inserted into the veins. In addition, the doctor will administer the anesthetic solution along the vein to prevent pain during the procedure.

• Next, the doctor uses a Doppler ultrasound to detect the veins. This procedure is similar to an ultrasound, the only difference being the blood vessels will be visible on the screen.

• Finally, the doctor makes a small cut or incision in the area where the catheter is to be inserted. The doctor will slowly guide the tube or the catheter into the varicose vein.

• The catheter comprises a laser fiber which will gently heat the tissues once the doctor pulls out the catheter. As a result, scar tissue forms on the area resulting in the shrinkage and closure of veins.

What Happens After Laser Surgery?

The patient will be asked to walk for 30 to 60 minutes after the procedure. There might be some bruising in the legs, which usually subsides in two weeks. However, the patient must have someone to drive him back home. In addition, follow the instructions mentioned below at home:

1. Apply a cold compress or an ice pack over the area for 15 minutes to reduce the swelling.

2. Check the incision site daily for discharge. Some patients might see light pink fluid on the bandage, which is normal.

3. Do only a sponge bath until the doctor removes the bandage.

4. The patient can wear compression stockings for a few days after the procedure to prevent swelling and pooling of blood.

5. The patient must raise his leg while sitting or standing for prolonged periods.

6. Avoid standing for a long time.

7. Stay active but refrain from doing strenuous exercises or lifting heavy objects.

8. The patient must take all the medications on time as recommended by the doctor to overcome pain and swelling.

What Are the Risks of Laser Treatment?

Though laser treatment is a simple procedure, some patients present with the following complications:

• Infections.

• Pain in the veins.

• Bruising.

• Bleeding.

• Tenderness or inflammation of the veins.

• Damage to the nerves.

• Formation of blood clots.

• Burns.

• Changes in skin color.

Conclusion:

Laser treatment is effective for visible leg veins because it is a painless and minimally invasive procedure wherein the patient does not have to undergo surgical trauma. Hence, this treatment has gained popularity over the past few years. However, the patient must consult the doctor to know more about the procedure's outcomes.