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What is endovenous laser ablation used for?

This question was asked in Framingham, Massachusetts and has 4 answer(s) as of 06/28/2016.
Is endovenous ablation only used for varicose veins or does it also work for spider veins? If so, how does the treatment process work for spider veins?


Doctors Answers (4)

Endovenous ablation is any treatment resulting in destruction of the inside (endovenous) lining of a vein. This usually refers to treatment of a large saphenous leg vein which is often responsible for developing into a varicose vein. Ablation may also involve a large branch or perforating vein that has venous reflux (abnormal venous flow) and often a varicose vein. Endovenous ablation can be done with a chemical treatment (sclerotherapy), and most often is treated with thermal destruction using either a fiber-optic laser or a radio-frequency catheter inside of a large vein, or most recently by some mechanical destruction such as using a rotating wire type catheter. Destruction of the inner lining of a vein by any method helps to close the vein. Spider veins in comparison are very small and are treated primarily with sclerotherapy and sometimes by laser.

It is not for spider veins. Endovenous laser is a laser that goes into the vein and heat seals it from the inside. Cutaneous laser is used on the outside of the skin for spider veins.

Endovenous laser ablation is used mainly to close the great or small saphenous veins that are responsible for varicose veins and symptoms of venous incompetence. Venous imcompetence means that the veins are not working properly. Saphenous veins that are not working can still cause symptoms even if varicose veins, which are usually branch vessels, are not present. The endovenous laser cannot be passed directly into a zig-zagging varicose vein; it is placed into a straight vein that may have caused the varicose vein. Occasionally spider veins improve after endovenous ablation of the great or small saphenous vein, but the spider veins are too small for a laser to be passed into them, which is what endovenous means. Other surface laser treatments can be done for spider veins in addition to sclerotherapy.

Endovenous ablation is for sealing larger non-functioning veins from the inside. These veins are the cause of the varicose veins. We use topical laser (on the surface of the skin) to treat some finer spider veins. However, a thorough examination using ultrasound and transillumination will see if there are "feeder or reticular" veins flowing into the area of the spider veins. Without injecting these, spider veins will continue to return. Larger surface spider veins are better injected leaving the laser for "clean up" of finer veins. Not all lasers are created equal. Seek a practice that has lasers specifically designed to deal with veins, such as Dornier or Cutera. These are more effective.

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