Laser Treatment Erases Varicose Veins

By Kim Ode
Minneapolis Star Tribune
Tuesday, August 11, 2009

Teresa Maruna is on her feet all day in her job as a kidney dialysis technician, so her legs would feel tired in any case. But sometimes the pain would become excruciating, she said, and her ankles would swell to the point that they "seemed not to be ankles anymore."

Maruna, of Lakeville, Minn., is among nearly 40 million Americans with vein disease. Over the years, treatment progressed from putting your feet up, to wearing support hose, to vein stripping (removing the enlarged vein). Now, less-invasive treatments are available, notably a laser technique that causes the vein to scar, collapse and be reabsorbed into the body.

"A varicose vein," said Tim Goertzen, a radiologist at a vein center in Eagan, Minn., "has a function, but when it's not functioning, its removal helps your whole body work better."

Varicose veins are physically painful, but there's also the emotional pain of having unsightly, ropelike veins. They're almost always on legs, because of how gravity affects pooling of the blood. In vein disease, a leaky blood valve interferes with the usual flow of blood; this results in weakening or stretching the walls of a vein.

Goertzen said that high heels, obesity and long hours of standing prevent your calf muscles from working as the pumps they're designed to be. But vein disease has genetic roots, with women three times as likely as men to develop it. Goertzen said physicians are seeing more vein disease as people live longer.

Until about 10 years ago, varicose veins were treated by surgeons, who removed the veins, but advances in ultrasound and radiology opened the field to others such as Goertzen, an interventional vascular radiologist.

"What makes this rewarding is when people have been told it's just something they have to learn to live with, or the treatments would hurt and put them out of commission for days or weeks," Goertzen said.

Maruna, 58, underwent a procedure called endovenous ablation, in which a catheter is inserted into the wall of the vein and travels its damaged length, using either a laser or radio frequency to cause the vein to scar shut. The blood is redirected through healthy veins and the collapsed vein is reabsorbed by the body within about six months.

The outpatient procedure is done with local anesthesia. Four days later, Maruna said, she was back to normal: "I got my ankles back."

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