Treatment for Varicose Veins Keeps Improving

Varicose veins stem from problems with the “superficial” veins in the legs — that is, those near the surface, located about half an inch below the skin. Like all leg veins, superficial veins have one-way valves that open as blood is pumped up toward the heart, and close to keep blood from flowing back down into the legs.

Over the years, the valves in a vein can become worn and stop closing properly. This can cause superficial veins to swell and puts pressure on branches of the veins, which become engorged and twisted.

To get rid of varicose veins, you must first shut down the malfunctioning superficial vein. That redirects blood flow through other (healthy) veins.

For years, the only treatment was a surgical procedure (called vein stripping and ligation) that required someone to go to sleep under an anesthetic so the surgeon could make an incision, tie off the problem veins, and pull them out. That caused significant bruising, discomfort, and swelling.

Starting in the 1990s, doctors began using a much less invasive procedure called thermal ablation. It involves closing the affected vein (without removing it) by threading a small catheter through the vein and using heat to make the vein collapse.

Updates in treatment for varicose veins

Newer techniques to close superficial veins include:

• Chemical ablation, in which the doctor injects a foam solution that causes the vein’s interior walls to scar and close
• Adhesive closure, in which the doctor uses a catheter to deliver a natural glue that pulls vein walls together
• Mechanochemical ablation (MOCA), in which the doctor uses a catheter with a rotating wire to damage the vein, along with a vein-scarring medication.

Those procedures often make small varicose veins disappear. If the varicose veins are large (and likely connected to other veins), doctors now have tools to remove them with a tiny incision or inject a medication that causes the varicose veins to scar and close.

The best treatment for varicose veins depends on your needs. They all require you to take it easy after treatment, and you’ll need to wear a compression stocking for a little while.

Another not yet FDA approved technology is high-intensity focused ultrasound (HIFU), which converts sound waves into a focused beam of heat that seals the vein. The treatment is done from the outside of the leg, almost like ‘zapping’ the varicose veins away.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.

©2024 Harvard University. For terms of use, please see https://www.health.harvard.edu/terms-of-use. Distributed by Tribune Content Agency, LLC.

Read more about skin health on Seniors Guide:

What Are Skin Tags?