Laser has been successfully used for many years for the treatment of a number of medical conditions.
A new technique is now available to deliver laser energy via an intravenous route (directly into the veins) to treat varicose veins. For the last decade thousands of patients have benefited from this minimally invasive technique all over the world. Treatment indications focus on superficial veins and perforating veins and a number of studies show excellent results.

Laser treatment of varicose veins reduces the risks of conventional surgery such as stripping, is almost pain free, can be performed as a day ward procedure and will allow you to walk away the same day with visible results. You will have to see your doctor before the procedure who will perform a series of tests, which are all pain free, completely safe as well as non-invasive and these will help your doctor to decide whether laser treatment is possible for you

During the treatment you will only need local anaesthesia, whereby a small amount of a topical anaesthetic agent (Lidocain) is injected under your skin. After a small knick into your skin, an optical fiber will be inserted into your vein which will allow the application of laser energy along the entire length of the varicose vein segment(s) destroying it from the inside. During the procedure you will wear goggles to protect your eyes from the laser light and the position of the laser will be constantly controlled via ultrasound to ensure its optimal position. You may feel a slight discomfort but no pain during and after the procedure.

Once the treatment is done you can immediately see the results and be able to walk away. Usually there is no swelling or bruising involved and scars are minimal (at the site of the incision).

WHAT YOU NEED TO DO AFTER THE PROCEDURE

To avoid any side effects and support fast healing, you should wear class II compression stockings for 1–2 weeks; those are comfortable and look like normal stockings. After you leave the day ward you should walk around for at least 30–60 minutes and you should continue to walk at least 1–2 hours daily for 1–2 weeks after the procedure. Hot baths, running, jumping, heavy lifting and straining should be avoided for 1–2 week. You can take Paracetamol or non-steroidal anti-inflammatory drugs such as Asprin or Voltaren if you feel any discomfort.

DO YOU NEED TO SE YOUR DOCTOR AGAIN AFTER THE PROCEDURE?

You will have a follow-up consultation within 10 days after the procedure with your doctor; however you should inform him if you experience any side effects such as bleeding from the site where the small knick was made in your skin or inappropriate pain at any time.
During the follow –up visit it will also be discussed whether some other additional care such as sclerotherapy may be needed for other small various veins.

Although the immediate and long term results of the laser treatment are excellent, you have to understand that varicose vein disease is a chronic and mostly progressive condition and it is recommended that you have an annual check-up and evaluation of your disease status even after successful laser treatment.

RISKS AND DISCOMFORT AFTER THE PROCEDURE

• Bruising in various levels will occur in the days following the procedure, this is benign and will spontaneously disappear within 10 to 15 days.
• Pain a long the path of the vein in the days after the procedure is possible (especially to the 4th or the 5th day, or around 8th -10th days), but in most cases, this pain is much relieved by ordinary painkillers (paracetamol) or anti-inflammatories and you can work as normal.

As with any treatment of varicose veins, the goal of laser treatment is to improve symptoms of which you complain. However, like all other treatments, in some cases, it may not change or partial improvement, and even worse can not be totally excluded.
Rare but possible adverse side effects can occur, such as:

• In the vast majority of cases, invasion a needle into a vein is not a difficult technique and does not cause of any serious problem, however, even rare, a dizziness may occur;
• Burns the skin over the vein and surrounding tissue (unusual by the technique of local anesthesia);
• Infections, is also rare but the risk of occurrence can not be totally excluded;
• Sensory neurological disorder in the path or in the region of the treated veins (such as tingling sensation or decreased sensitivity). In some exceptional cases it may caused neurological movement disorder (such as weakness or paralysis of a muscle or part of a muscle). Neurological disorders may be last long for several months or even leave lasting effects;
• Perforation of the vein (causing a bruise just larger);
• Breaks the fiber laser causing bigger guide-path: very exceptional risk, especially as nowadays the hardware is more secure;
• Superficial or deeplying venous thrombosis (inflammation and obstruction of vein), formerly known as “phlebitis.”;
• Some hyperpigmentation (brown spots on the skin), or the appearance of small blood vessels under the skin have been described;
• Very exceptionally, an allergy in connection with local anesthesia call anaphylactic shock may occur requiring resuscitation and may be life-threatening;

We also can not completely eliminate the possible occurrence of side effects not listed until today.

WHAT ARE THE POSSIBLE COMPLICATIONS SHOULD YOU DECIDE NOT TO DO THE LASER TREATMENT?

Varicose veins is a chronic progressive condition which you may have inherited.
Without treatment, the symptoms such as heaviness of the legs, swelling, pain, itching will worsen as will increase the number and size of the varicose veins.
A number of other factors can also contribute to a worsening of the disease such as a job where you have to stand for long hours, if you are pregnant or have gained a bit too much weight recently and others.
You may experience complications from varicose veins such as discoloration of the skin, which is unfortunately permanent, inflammation and ulcers and you have a higher risk to develop a blood clot in your superficial and deep veins.

As for all diseases it is better to prevent worsening and complications from happening than later, having to treat them.

WHAT OTHER TREATMENT OPTIONS DO YOU HAVE?

In the vast majority of cases, varicose veins are not life-threatening and treatment is, although highly recommended, not mandatory from a medical point of view.

Other treatment options for varicose veins include:

• Conventional surgery (stripping) which is mostly performed under general anesthesia and is a major intervention causing bruising and swelling. Recovery time is commonly a couple of weeks, during which you will most likely be unable to work.
• Echosclerotherapy treatment is an ultrasound guided injection technique for the treatment of varicose veins. This technique is minimally invasive, simple, effective, but the results are limited and less durable especially on large caliber saphenous veins (the large, subcutaneous, superficial vein of the leg. It is the longest vein in the body running along the length of the leg) (recurrence of thrombosis, phlebitis)
• Radio- high-frequency treatment which is similar to laser treatment but cannot be applied for patients with tortuous veins

WHAT ARE THE RISKS AND WHAT ARE THE BENEFITS OF LASER TREATMENT?

The benefits of the laser treatment is that varicose veins will either completely disappear or be at least dramatically reduced which has a health benefit and also improves the looks of your legs. The venous blood flow will be improved and the symptoms you have been experiencing will be less or completely disappear. As with any other technique, there is no guarantee for a 100% satisfaction rate but it is highly unlikely that you will not experience any sort of improvement or even worsening of the symptoms.