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| |  DG DISPATCH - AAD: Latest Treatments for Varicose and Spider Veins By Maggie Schwarz Special to DG News
WASHINGTON, DC -- March 7, 2001 -- Speaking at the American Academy of Dermatology’s 2001 Annual Meeting, Robert Weiss, MD, Johns Hopkins School of Medicine, Baltimore, discussed newly available treatments for varicose or spider veins.
Varicose Veins "A new procedure to treat varicose veins called radio-frequency closure is minimally invasive," Dr. Weiss said. "Patients can now be treated, then play golf the same afternoon instead of the traditional two weeks of recovery after surgery." Radio-frequency closure involves inserting a catheter into the defective vein. The catheter delivers radio-frequency energy to the vein wall, causing the vein to shrink and seal shut. After the diseased vein closes, neighboring veins take over to restore normal outflow of venous blood from the legs. Other advancements include hooks that are less traumatic and can be placed through smaller incisions. These hooks are used for ambulatory phlebectomy, a procedure whereby tiny punctures are made to extract large varicose veins near the skin’s surface. Also new is the Klein tumescent anesthesia pump, which can inject larger volumes of anesthesia at lower concentrations with less discomfort to the patient. This pump allows local delivery of anesthesia, so the patient can be on his or her way after undergoing varicose treatment with no recovery period and no local pain.
Spider Veins Until recently, lasers were used primarily for spider veins found on the face. The legs were difficult to treat with lasers because the skin is thicker and blood vessels comprising spider veins are deep. Furthermore, patients with spider veins often tan their legs to help hide their condition, which not only increases their risk of developing skin cancer, but makes it harder to treat with lasers. With most lasers, penetrating through a tan or naturally pigmented skin is risky, since the darker color absorbs most of the laser energy and can burn the skin. But a new laser, the Nd:YAG 1064 nm, uses wavelengths beyond visible light to penetrate the skin without heating the pigment, thereby reducing the risk of burning the skin. Another improvement in laser treatment of spider veins is a new cooling method that protects the skin and makes the procedures less painful. The cooling device is sprayed on after the laser pulse to reduce heat injury, as the vein cools down after the laser pulse is delivered. Also new is a polarizing scope, which makes spider veins appear three-dimensional, making them easier to see and treat. "Advancements in treating spider veins really are of great benefit to the patient," Dr. Weiss explained. "Treatment is more effective with fewer side effects, and patients resume normal activity immediately."
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