Varicose Veins: Treatment

The treatment options for varicose veins have significantly improved. Ablation of the saphenous vein by the VenaCure  laser vein treatment is an office based procedure we perform that is much less invasive than traditional vein stripping, has a minimal complication rate, is very well tolerated and produces excellent cosmetic results and relief of symptoms.

VenaCure works by thermal ablation of the vein lumen. The saphenous vein is cannulated under local anesthesia and a laser fiber is passed through the vein lumen. When the laser is turned on, the direct release of thermal energy irreversibly damages the vein wall causing nearly immediate and permanent obliteration of the vein lumen.

Three randomized trials have compared VenaCure to standard vein stripping. In every measured category, VenaCure surpassed vein stripping with faster recuperation, less post-procedure pain, fewer adverse events, and a superior quality of life score. Patients typically return to near normal activities within two days. Furthermore, the lasting benefits of VenaCure were confirmed. At two years follow-up, 93.4% of VenaCure treated legs were free of reflux compared to 91.7% of surgically stripped legs. Additionally, quality of life and pain scores were significantly better at two years for patients treated with VenaCure compared to open surgical methods.

Three year data has been reported by Min et al on 499 limbs treated with VenaCure. Saphenous vein closure at 6 months was 98.5%, at 1 year 97.5%, and at 2 years 93.4%. Navarro reported a 95% success rate in 200 legs at four year follow-up evaluations.  

In addition to obliterating varicosities, VenaCure can promote healing of skin ulcerations related to chronic venous insufficiency.  VenaCure can produce as much as an 80-90% reduction in skin ulcerations.

Adverse events are typically limited to mild ecchymosis and a transient “pulling” sensation in the thigh. The more typical complications of open stripping such as leg pain, paresthesias, hematoma, and deep vein thrombosis are exceptionally rare with VenaCure.

Patients must be screened before undergoing the procedure. Frequently those with very superficial and tortuous varicosities may not be appropriate candidates for VenaCure. Endothermal treatment of very superficial veins may produce a poor cosmetic result. Extreme vein tortuosity can make passage of the laser probe difficult and may, in some instances, preclude successful VenaCure. These patients can usually be treated successfully in our office by venous sclerotherapy or by micro-phlebectomy (direct surgical removal of the vein branch).

We have been exceptionally pleased with our results using VenaCure and our patients have been very pleased with their outcomes.