Register for New Noninvasive Procedures Treat Leg Veins Problems
DermatologyDecember 3, 2001
2001 DEC 3 - (NewsRx.com & NewsRx.net) -- For the approximately 80 million Americans affected by venous disease, covering up their varicose or spider veins with clothing, cosmetics or, in the worst case, a suntan is as much a part of their daily routine as brushing their teeth or combing their hair.
The reason is simple - leg veins are noticeable and, in some cases, embarrassing for the men and women who live with them. But while some people can manage masking the cosmetic problems associated with leg veins, others can't ignore the persistent leg pain and other physical symptoms caused by this common medical condition.
Speaking October 17, 2001, at the American Academy of Dermatology's Derm Update 2001, dermatologist Neil Sadick, MD, clinical professor of dermatology, Cornell University Medical College, New York, New York, discussed the latest non-invasive treatment options available for patients with varicose and spider veins.
Varicose veins are abnormally swollen or enlarged blood vessels caused by a weakening in the vein's wall, which often leads to pain and swelling in the leg. Varicose veins occur from the backward flow of blood in the legs caused by damaged or diseased valves in the veins. In the past, when the largest superficial veins were involved, the only alternative was surgery with stripping of the defective vein, a procedure that involves making an incision in the skin and either tying off or removing the blood vessel.
A new procedure to treat varicose veins called the Radio Frequency Closure technique, commonly referred to as the closure technique, involves inserting a small tube called a catheter into the defective vein through a small puncture. An early pioneer of this technique, Sadick explains that a catheter delivers radio frequency energy to the vein wall, causing the vein to shrink and seal shut. Once the diseased vein is closed, neighboring healthy veins take over to restore normal outflow of venous blood from the legs. As normal blood flow returns, symptoms are typically reduced.
"The Closure technique is truly a revolutionary way to treat varicose veins because patients do not feel any pain either during the procedure or post-operative, and they can return to their daily activities immediately," said Sadick. A single treatment lasting 45 to 60 minutes can eliminate the most common leakage point of varicose veins using tumescent anesthesia. The procedure is virtually pain free.
Another new procedure to treat varicose veins that has been studied over the past two years is the endovascular laser procedure. Unlike traditional laser procedures where the laser beam zaps the skin through the laser itself with long or short pulses of light, the endovascular laser procedure uses a diode laser wire or fiber that is inserted directly into the vein. The laser fiber physically penetrates the skin to deliver the laser energy directly into the vein.
The energy transmitted from the laser heats the varicose vein, causing it to be destroyed. The entire procedure takes approximately 30 to 60 minutes and side effects are minimal with the exception of some postoperative bruising. While patients can return to work the next day, a support stocking must be worn for 10 to 14 days following the procedure.
"Although only about a dozen dermatologists across the country are performing the endovascular laser procedure, I expect that it will become a viable treatment option for patients with varicose veins in the next few years," added Sadick. "It's a quick, relatively painless procedure and initial studies have been very promising."
Spider veins are dilated small blood vessels located close to the surface of the skin that have a red or bluish color. Although they can appear anywhere on the body, spider veins typically occur on the legs and face.
Until recently, lasers were used primarily for facial veins, which are small, superficial and red. The legs have been difficult to treat with lasers because the skin is thicker and the blood vessels comprising the spider veins are deeper than those elsewhere on the body. In addition, patients with spider veins often tan their legs to help hide their condition - which not only increases their risk of developing skin cancer, but makes it harder to treat with lasers.
In the past, most lasers could not penetrate through a tan or naturally pigmented skin since the darker color absorbs most of the laser energy and can burn the skin. But now a new laser, the Nd:YAG 1064nm, uses wavelengths just beyond visible light to penetrate the skin without heating the pigment, thereby reducing the risk of burning or injury to the skin. This makes the 1064 nm laser much safer for Asian, African-American, Middle Eastern and tanned skin.
Typically, two to five laser treatments are required to remove the spider veins completely depending on the severity and density of the veins. Each session lasts approximately 15 minutes, and the treatment feels like the pinch or snap of a rubber band.
Cooling devices are another important improvement in lasers used to treat spider veins that aids in protecting the skin and makes the procedure less painful. After the laser pulse is administered to the vein, the cooling device is sprayed to reduce heat injury as the vein cools down.
"Patients with spider veins have more options than ever before in treating this previously hard-to-treat condition," said Sadick. "What's particularly appealing with laser treatment for spider veins is that there is virtually no downtime and patients can go back to work immediately following the procedure. I think we can continue to expect even more advances in treating spider veins, making patients more confident about their options and outcomes." This article was prepared by Health & Medicine Week editors from staff and other reports.
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