|
E-mail this page to a friend!
Now All Causes of Varicose Veins Can Be Treated
Nonsurgically
April 4, 2005 Varicose veins occur in two of
every three people 50 and older, and for these sufferers there is good
news from the 30th Annual Scientific Meeting of the Society of
Interventional Radiology, where a study has been presented saying all
causes of varicose veins can now be treated by laser and the researchers
report a 96 percent success rate.
Two-year data in over 200 patients show the 96
percent success rate for treating the non-great saphenous veins, which
include the anterior accessory great saphenous vein, the small saphenous
vein, and the posterior thigh circumflex vein. This is the first large
study to investigate treating faulty non-great saphenous veins, a
frequent but often under-diagnosed cause of varicose veins, and these
results are superior to those reported for other treatments of vein
reflux in these veins, including surgery, ultrasound-guided
sclerotherapy, and radiofrequency ablation.
Endovenous laser ablation is a safe and highly
effective treatment for a common but under-recognized cause of varicose
veinsreflux in small saphenous, accessory saphenous, or other
previously difficult to treat veins, collectively referred to as
non-great saphenous veins, according to results of the study presented
today. To treat the vein reflux, laser energy is applied inside the
faulty vein to seal it closed. The treatment requires only a nick in the
skin and local anesthesia.
The laser treatment is already proven to be a
highly effective treatment for reflux in the great saphenous vein, which
is the most common underlying cause of the visible varicose veins below.
However, in at least 20 percent of patients, which equals millions of
people in the U.S. alone, varicose veins are caused by non-great
saphenous veins or a combination of both types.
This new study means that millions of patients
will now have an effective nonsurgical treatment for their varicose
veins. Until now, there havent been effective treatments for these
types of veins, says Robert J. Min, MD, MBA, Interventional
Radiologist, Cornell Vascular, New York. Surgical removal of varicose
veins, even in the best series, has about a 25 percent or higher
recurrence rate. In equivalent time periods laser ablation has had a
recurrence rate of less than 5 percent.
In this study, lead author Min adapted the laser
procedure, which he first pioneered to treat great saphenous vein
reflux, to treat the non-great saphenous veins. The study also showed
that this new application of the treatment is very safe. No skin burns,
deep vein thromboses, or other heat-related complications were reported.
The laser treatment is more effective than surgical ligation stripping
and has many benefits. It can be done as an outpatient procedure,
typically in less than an hour, and patients can return to normal
activities immediately. There is little to no pain, no general
anesthesia, and no scar, says Min.
About the Study
Over a 56-month period, the study included 204 limbs in 192 patients
with varicose veins not caused by great saphenous vein reflux. Of the
204 limbs treated, 104 were treated for anterior accessory great
saphenous vein (AGSV) reflux, 86 for small saphenous vein (SSV) reflux,
and 14 for posterior thigh circumflex vein (PTC) reflux. The subjects
were treated with 810 nm laser energy delivered endovenously via a 600
micron fiber.
Successful occlusion of the vein, defined as
absence of flow on color Doppler, was achieved in 101 of 104 (97%) AGSVs,
83 of 86 (93%) of SSVs, and 13 of 14 (93%) of PTCs at follow-up after a
mean of 24 months (up to as much as 53 months). The studys authors
noted that of the seven failures, which all occurred early in the study,
six occurred before the six month follow-up, indicating that the failure
may have been due to inadequate treatment rather than recurrence. All of
these cases were successfully retreated.
About Varicose Veins
Varicose veins affect one out of two people age 50 and older, and 15 to
25 percent of all adults. They are caused by venous insufficiency, an
abnormal circulatory condition characterized by decreased return of
blood from the leg veins up to the heart and pooling of blood in the
veins. Normally, stop valves in the vein close to keep blood from
flowing downward with gravity. But when the valves in the vein become
weak and dont close properly, they allow blood to flow backward, or
reflux. Varicose veins are prominent veins that have lost their valve
effectiveness and, as a result of dilation under pressure, become
elongated, rope-like, bulged and thickened. Risk factors for varicose
veins include age, family history, female gender and pregnancy.
Symptoms
Symptoms caused by varicose veins include aching leg pain, easy leg
fatigue, and leg heaviness, all of which worsen as the day progresses.
Many people find they need to sit down in the afternoon and elevate
their legs to relieve these symptoms. In more severe cases, this can
cause skin discoloration and leg ulcers. People without visible varicose
veins can still have symptoms. The symptoms can arise from spider veins
as well as from varicose veins, because, in both cases, the symptoms are
caused by pressure on nerves by dilated veins.
About the Laser Treatment
This minimally invasive treatment is an outpatient procedure performed
using duplex ultrasound imaging for guidance. As vascular experts,
interventional radiologists use their training in diagnostic imaging to
determine which faulty veins are the underlying cause of the problem and
precisely locate the reflux. After applying local anesthetic to numb the
vein, a thin catheter, about the size of a strand of spaghetti, is
inserted into the vein and, using ultrasound, is guided inside the vein.
Then laser energy is applied to the inside of the vein to heat the vein
and seal it closed. Sealing the faulty vein improves the circulation in
the leg by redirecting the blood to normal veins. Abnormal veins are not
useful and they actually create more work for the normal veins in
returning blood back to the heart.
There may be minor soreness or bruising, which can
be treated with over-the-counter pain relievers. There is no scar,
because the procedure does not require a surgical incision, just a nick
in the skin, about the size of a pencil tip.
About Interventional Radiology
An estimated 5,000 people are attending the Society of Interventional
Radiologys 30th Annual Scientific Meeting in New Orleans.
Interventional radiologists are board-certified physicians who
specialize in minimally invasive, targeted treatments performed using
imaging for guidance to treat diseases nonsurgically through the blood
vessels or through the skin. By combining diagnostic imaging expertise
with advanced procedural skills, interventional radiologists perform
minimally invasive treatments that have less risk, less pain, and less
recovery time than open surgery. Interventional radiologists pioneered
minimally invasive modern medicine with the invention of angioplasty and
the catheter-delivered stent, which were first used to treat peripheral
arterial disease. More information can be found at
http://www.SIRweb.org.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
