Varicose veins are twisted, dilated veins and are most commonly located on the calves and thighs. Risk factors for getting varicose veins include chronic coughing, constipation, family history of venous disease, being female, obesity, older age, pregnancy, and prolonged standing. The exact pathophysiology is not clear, but most experts agree it
involves a genetic predisposition, improperly working veins, and increased blood pressure in the veins of the legs.
Varicose veins are not only an aesthetic issue. They can also create a sensation of heaviness in the leg, along with itching, burning, and discomfort. Potential complications include infection, leg wounds that don’t heal, and blood clots. Avoiding long periods of standing or straining, elevating the legs, wearing support hose for external compression to help evenly distribute blood flow, and wearing loose clothing on other parts of the body to prevent pushing blood flow into the legs can all help. Medical options include external laser treatment, sclerotherapy, endovenous laser ablation (EVLA) treatments, and surgically removing the veins from the leg. The choice of therapy is often affected by cost, available medical resources, and physician training. (Source: American Family Physician, December 2008, pages 1289-1294.)
Among the treatments, EVLA is considered by far the most reliable; it offers the best long-term results, is less invasive, and is the least painful of all the options for varicose veins. Outcomes from EVLA appear to be equal to or better than stripping, with better quality-of-life scores in the postoperative period, but in addition EVLA has been shown to improve and strengthen the veins, preventing further occurrences (Source: Journal of Vascular Surgery, July 2008, pages 173-178).
EVLA works by destroying the varicose vein through the introduction of heat. A thin tube is inserted into the vein and a tiny laser pulse is emitted; a variety of wavelengths can be used, such as 810, 940, 980, 1064, and 1320 nanometers. When the laser is triggered, it generates targeted, intense heat to the specific vein, destroying it; the tissue is then reabsorbed by the body (Source: Emedicine, November 7, 2008, http://emedicine. medscape. com/article/1085735-overview).