From the Guidelines
Varicose veins can be effectively treated with endovenous ablation, which has largely supplanted surgical ligation and stripping as the main invasive method, offering similar efficacy, improved early quality of life, and reduced hospital recovery 1.
Treatment Options
The most common options for treating varicose veins include:
- Endovenous laser treatment (EVLT) or radiofrequency ablation, where heat is used to seal off problematic veins
- Ambulatory phlebectomy, which removes veins through tiny skin punctures
- Vein stripping and ligation for more severe cases, involving surgical removal of the affected veins
- Sclerotherapy, which involves injecting a solution into the veins to make them collapse and fade
- Compression stockings (20-30 mmHg pressure) worn daily can help manage symptoms before pursuing invasive treatments
Procedure Details
Endovenous ablation uses either radiofrequency ablation (RFA) or endovenous laser ablation (EVLA) to destroy damaged veins. Both treatments use tumescent anesthesia to protect surrounding tissue and collapse the vein wall extrinsically 1.
Recovery and Outcomes
Most procedures are outpatient, requiring minimal recovery time of 1-2 weeks with normal activities typically resumed within days. Endovenous ablation has been shown to have fewer rates of bleeding, hematoma, and wound infection compared to surgery, as well as reduced rates of paresthesia 1.
Recommendations
The best procedure depends on the severity of your condition, vein size and location, and your overall health, so consultation with a vascular specialist is essential for personalized treatment recommendations. Recent meta-analyses confirm that EVLA and RFA are at least as efficacious, if not slightly more so, than surgery, with similar quality of life benefits and durability 1.
From the Research
Procedures to Fix Varicose Veins
The following procedures are used to fix varicose veins:
- Endovascular treatments, such as endovenous laser therapy (EVLT) and radiofrequency obliteration (RFO) 2
- Surgical treatments, including high saphenous ligation and sclerotherapy 3
- Herbal treatments, which can improve quality of life and reduce secondary complications of varicose veins 4
- Sclerotherapy, which can be used alone or in combination with other treatments, such as RFA 5
- Phlebectomy and perforator ligation, which can be used in conjunction with other treatments 5, 6
Treatment Options
Treatment options for varicose veins include:
- Endovenous ablation techniques, such as thermal and nonthermal ablation of the superficial truncal veins 6
- Open surgical treatment, including ligation and stripping 6
- Foam sclerotherapy, which can be used to treat residual significant varicosities 5
- Liquid sclerotherapy, which can be used to treat varicose tributaries 6
Considerations for Treatment
When considering treatment for varicose veins, the following factors should be taken into account: