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Varicose veins are the veins that are enlarged and twisted. Because of its appearance, varicose veins are also known as spider veins. The term varicose vein is generally used for the enlarged and swollen veins in the leg, though the condition can possibly affect any part of the body. Varicose veins are not a problem unless there is an extensive pain and swelling, discomfort, and wound opening at the affected site.

The vein valves that prevent the backflow of blood lose their integrity, thus leading to backflow of the blood. This causes swelling and inflammation of the leg, requiring varicose vein treatment or vein removal. Varicose veins are common in superficial veins that are prone to increased pressure when standing.

The following therapies may be used for varicose vein treatment:

  • Sclerotherapy
  • Foam sclerotherapy
  • Laser surgery (endovenous laser treatment)
  • High ligation and vein stripping
  • Ambulatory vein phlebectomy
  • Endoscopic vein surgery

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Before the Treatment

The type of preparation that you will be required to undergo depends on the type of procedure that you are scheduled to undergo. The doctor will first make a thorough assessment of your overall health and then based on the evaluation, would recommend you a procedure that best meets your requirement.

Before undergoing a laser surgery for varicose veins, make sure to do the following:

  • Ask any queries related to the surgery.
  • Enquire about any allergies or sensitivities to the medicines.
  • Inform about the use of blood thinning medications which may need to be stopped before the surgery.
  • Tell the physician about the medications used. Also, inform about the diet and herbal drugs, if used.
  • The physician may suggest avoiding eating and drinking 8 hours before the surgery.
  • Discuss with your doctor in detail about your medical history. People with blood clotting problems are never advised to go for such treatment. The doctor will anyway take a profile of your blood to understand the health condition.
  • Have realistic expectations from the procedure, so have a detailed discussion of what to expect at the end of the surgery.

How it is Performed

The sequential steps of the endovenous laser treatment (EVLT) are:

  • The patient will be instructed to wear the surgical gown. Special eyeglasses are provided to prevent damage from the laser light.
  • The primary healthcare provider will anaesthetize the area where the catheter is to be inserted. Local anaesthesia is provided to the vein which has to be operated.
  • A Doppler ultrasound device is used to check the vein before and after the treatment.
  • This process involves the use of sound waves across the vein by which the image of the vein is displayed on the computer.
  • The provider will make a small incision in the skin of the affected leg, and a catheter is inserted. A beam of laser light is then passed through the catheter.
  • The catheter is then pulled out, and the skin is dressed.
  • The vein will close and eventually absorbed by the body.


  • The physician may ask you to walk immediately after the surgery for about 30-60 minutes.
  • The bruises of the surgery would fade in about 2 weeks. The physician may advise you to do certain things at home.
  • Put ice-pack over the swelling for at least 15 minutes.
  • You should check the incision area every day. Light pink fluid over the bandage is a common observation.
  • Avoid exposing the incisions to moisture or water for at least 48 hours. Better take a sponge bath till the bandages are removed.
  • Avoid sitting or standing for a longer duration, raise the legs while in rest.
  • Make a practice of wearing compression stockings for few weeks. This helps to prevent the pooling of the blood in the leg and prevents the swelling of the leg.
  • Walk for 10 to 20 minutes each day for at least 10 days.
  • Take proper precautionary measures while using over-the-counter drugs. Clarify with the physician before the use of the drugs.

The physician should be consulted when there is redness, warmth, and fluid drainage from the incisions after spider vein treatment. Increasing pain and swelling should also be reported.

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Q. Will I need further treatment?

A. Further spider vein treatment is usually not required after EVLT. But additional treatment would benefit if the varicosities are severe. The treatment may include avulsions or foam sclerotherapy. The laser treatment reduces the symptoms but does not cure permanently.

Q. Which procedure is right for me?

A. Most of the patients get confused as to which procedure is to be followed. The specific procedure depends on your surgeon. Usually, an absence of treatment would be most beneficial; care should be taken to prevent further varicosities from appearing

Q. Am I suitable candidate for EVLT?

A. Almost all the patients are suitable for EVLT. Those who have recurring varicosities after the laser treatment should opt for foam sclerotherapy.

Q. What can I expect after the surgery?

A. You may need additional therapies to completely cure of varicose veins. You will have to wear loose garments as the operated legs will be bandaged after the surgery

Q. What are the other options to treat varicose veins?

A. The surgery may be avoided, but as there is a progression of the varicose veins, constant evaluation is required. Special stockings may be required to support the swollen legs. Physician’s consult could be beneficial.

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