Is treatment of varicose veins safe in the long run?

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.


Best,
Dr. Karamanoukian
Realself100 Surgeon

EVLT is a safe procedure.  Once the great saphenous vein is closed, the blood will be re-routed into the normal veins and it will flow properly.  If you have saphenous reflux, the proper first line of treatment (after conservative care) is to treat the reflux with some sort of an ablation procedure, of which there are numerous options.  EVLT is one of those options.

As a cardiovascular surgeon I can assure you that there won't be a problem getting blood back to the heart unless you have a preexisting complete occlusion (thrombosis) of major veins in the legs or pelvis. The procedures (EVLT) are safe in experiened hands. H Karamanoukian MD FACScertified vein specialist (ABVLM) and double board certified surgeon

The gold standard for treatment of varicose veins due to saphenous vein reflux is a closure procedure. There are 3 levels of veins in your leg, superficial, connecting and deep.  The saphenous vein is in the superficial system so once this is closed blood will return to the heart through the other two systems.

EVLT is a very safe procedure. 98% closure of the great saphenous vein is achieved at one year as confirmed by an ultrasound. Small risk of a deep venous thrombosis (DVT) needing a blood thinner. The deep system of veins is responsible for taking the majority of blood back up to the heart. EVLT should treat a diseased vein, one that does not efficiently return blood back up to the groin area so occluding or closing the vein should improve your venous return and not impede it. EVLT should be offered for symptomatic patients and not varicose veins without symptoms. 

EVLT is effective in ablating the saphenous vein that is refluxing. The re-opening rate after closure is about 0-2% when done by EVLT. The venous circulation becomes more efficient because blood is circulated back to the heart via the deep venous system and the remaining superficial venous system. We have performed over 1500 EVLT procedures and patients have benefitted tremendously afterwards. 

Once the saphenous vein is closed, the blood that was using that vein gets rerouted to the healthy veins and drains from your leg as it is supposed to do.  Closing down a diseased vein that is actually allowing blood to fall backwards in the leg will actually improve your circulation in the long run and prevent some of the long term consequences of venous reflux disease. 

While varicose veins can be hereditary, there are several other factors that can increase your risk of developing vein disease. These are age (aging causes wear and tear on the valves in the legs), obesity (extra weight adds increased pressure to the veins), standing or sitting for prolonged period (as one position does not allow frequent flow). This being said, there are still many cases where vein disease occurs for no clear reason. 
While we don't know the exact cause of your vein disease, your circulation will still function properly post treatment. This is because the blood is rerouted into healthy veins that are at less of a risk to develop these issues. Your veins will be able to pump blood back to your heart and the symptoms and complications that are usually present with varicose veins (leg heaviness, cramping, burning, swelling, etc) will be greatly reduced, if not eliminated. 

There are 2 sets of veins in the leg:  Deep veins underneath the muscles and superficial veins between the muscle and the skin.  The deep veins are the important emptying veins in the legs, pumping blood back to your heart and lungs as you walk and contract the muscles in your legs.  The superficial veins, of which the great saphenous is the longest, collect blood from the skin and soft tissue and then empty it into the deep veins to be carried up and out of the legs.  The saphenous as an emptying vein, does very little, carrying less than10% of the blood out of the leg. If the saphenous is not functioning properly, it's allowing back flow into the legs, holding more blood than it should, and often causing symptoms of congestion.  These may include aching, fatigue, swelling, leg cramps and itching of the skin.  In those cases, closing the great saphenous actually makes the emptying of blood from the leg more efficient- no more backwards flow. It doesn't hurt the emptying ability of the deep veins.