Endovenous laser ablation is a safe and highly effective treatment for a common cause of varicose veins

Endovenous laser ablation is a safe and highly effective treatment for a common but under-recognized cause of varicose veins -- reflux in a variety of veins collectively referred to as non-great saphenous veins -- according to results of a study presented today at the 30th Annual Scientific Meeting of the Society of Interventional Radiology.

Varicose veins occur when valves in the vein become weak and don't close properly, which allows blood to flow backward, or reflux. 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.

Two-year data in over 200 patients show a 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, 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.

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 varicose veins. However, in at least 20 percent of patients, which equals millions of people in the United States 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 haven't 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.