Varicose Veins Treatment


Many patients with varicose veins accept their fate. They endure their complaints with the idea that they have no choice but to live with their varicose veins and that they will recur even if they are treated. However, treatment methods for varicose veins are increasing day by day and unfortunately many patients continue their lives without knowing this…

What is varicose veins?

Although varicose veins are known as the enlargement of the veins, it is a condition that causes not only aesthetic but also serious health problems. Its definition dates back thousands of years. So much so that in the 5th century BC, Hippocrates mentions the treatment of varicose veins. Despite this, developments in the treatment of varicose veins have been in the last century. Varicose veins are of various types according to vein size. Varicose veins under 1 mm in size, especially in the legs, where thin capillaries are observed like a spider web, are called telangiectasia. Varicose veins between 1-3 mm, in which slightly thicker veins are observed, are called reticular varicose veins, while those of 3 mm and above are those strangulated veins that we now know as varicose veins.

So why do these varicose veins occur?

As a matter of fact – although not fully proven – varicose veins are often inherited from the family, so genetic predisposition is very important. So much so that if both parents have varicose veins, almost 60% of the child can develop varicose veins. But it is not only our parents who are responsible, but also our own preferences play a very important role among the causes. Especially our lifestyle, profession and gender, even the clothes we choose are important. Barbers, hairdressers, nurses, surgeons, surgeons and shop assistants, who are among the occupational groups that spend more time on their feet, are among the most risky groups. There are many other factors such as obesity, pregnancy, certain medications (especially hormone medications used in women), sedentary life.

How do varicose veins occur?

Varicose veins occur as a result of the body’s vein system, especially in the legs, not working well. The veins in the legs work against gravity and transport the dirty blood from the legs to the heart. As such, there are valves in the veins to prevent this blood from escaping back. With the deterioration of these valves, varicose veins begin to develop. Varicose veins may not be visible externally in every patient. Especially in overweight people, the veins under the fat tissue may not be noticeable. However, varicose veins may make itself felt with other complaints. Pain that increases especially later in the day, itching in the legs, night cramps and swelling are among the common complaints. In addition, varicose veins can cause skin cracks and bleed.

Is it possible to prevent varicose veins?

Of course, varicose veins are a natural condition that occurs as long as human life continues. However, it is also possible to reduce varicose veins with lifestyle changes. First of all, we should try not to gain weight and lose the weight we have gained. If we smoke, we should quit immediately. In addition, it is important not to stay standing for a long time unless we have to, to rest by stretching our legs, not to wear tight pants and tights, especially for women, to avoid the use of high heels, not to be sedentary, to stay away from hot environments such as saunas and spas. In addition, sports such as walking and swimming, comfortable and lose clothes and the use of compression stockings are useful practices.

Is there a cure for varicose veins?

There is a misconception among the public that varicose veins cannot be treated or will recur. This is the most common question that patients ask us; “Will it recur after treatment” and “what will happen if it recurs”. People with varicose veins should definitely be examined by cardiovascular surgeons. Today, we have treatment options for varicose veins. The traditional method in the treatment of varicose veins was open surgery and we still continue to apply it in some patients. In the treatment of varicose veins, we first check whether there is venous insufficiency in the deep and superficial vein system by performing a doppler ultrasound. If there is no such condition and the patient has capillary varicose veins (telangiectasia), we apply sclerotherapy, radiofrequency or laser treatment to them. If there is a leak in the superficial venous system (vena saphena magna and parva) and it is advanced, we can perform varicose vein surgery in a short time with laser, radio frequency or special adhesives. Patients are discharged on the same day and are very satisfied as there are no stitch marks on their legs.

Wait for the right time for varicose veins treatment, the right treatment is winter and spring months!

The time of treatment is as important as the treatment of varicose veins, which cause complaints such as blue-purple colored veins, pain, fatigue, itching, feeling of heaviness and cramps in the legs.

Treatment in times of intense sunlight is not suitable for varicose veins treatment. Treatments performed in the winter months also positively affect the success rate. It is necessary to stay away from the sun’s rays in order to avoid pigmentation and staining, especially after the treatment of capillary varicose veins on the legs. In addition, since compression stockings should be worn as long as recommended by your doctor after the treatment, the appropriate time for varicose veins treatment is the winter and spring months. With the treatment at the right time, you can enter the summer months with healthier and more aesthetic legs.


Remember, it is very easy to get rid of your varicose veins ……


Laser treatment for varicose veins in the leg veins has been practised since 1998. This method, which has been applied in our country since the early 2000s, has surpassed open surgeries all over the world.

Before the procedure, a kind of mapping is performed by evaluating the vein system to be intervened with the imaging method called Doppler ultrasound.
The procedure is performed under local anesthesia and with ultrasonography. The large superficial vein (great saphenous vein) just inside the knee is visualized with ultrasound and a needle is inserted into the vein. It is usually a painless procedure. Then, under the guidance of Doppler ultrasound, the laser catheter is advanced along the leaking large superficial vein and placed 2 cm behind the point where the vein connects to the deep anatoplar vein. The location of the catheter is precisely determined visually under the skin using ultrasound and laser light. At this stage, local (tumescent) anesthesia is applied along and around the vein to prevent nerve and skin damage. The purpose of this application is to prevent damage to the tissues. Because the temperature can reach very high values in the areas where the energy is concentrated. The most commonly used wavelength in the laser procedure is 980 nm. The laser power is usually set between 10-15 watts and the average energy is given per cm is 65-100 joules. As a result of the heat and contraction caused by the laser energy transferred through the catheter on the vessel wall, the vessel shrinks and closes. If present, small incisions can be made in the varicose vein pockets raised above the skin with the microphlebectomy method. At the end of the procedure, a doppler ultrasound should show that the vein is completely closed. After the procedure, the patient’s leg is routinely wrapped with an elastic bandage and the leg remains bandaged for 2 days. After the bandage is removed, it is recommended to wear compression stockings with a pressure of 30-40 mmHg for a period of 2-3 weeks until complete healing occurs.

Intravenous Laset treatment cannot be applied to pregnant women, patients with arterial disease in the legs, bedridden patients, patients with newly developed deep vein occlusion, patients with bleeding or thrombosis-prone diseases.

Laser applications into the veins are very safe procedures and have a low rate of side effects, especially when performed by experienced clinics. However, as with any procedure, some side effects may occur.
* In the first few weeks after the procedure, a slight numbness and pulling sensation may be observed in the thigh area, but it resolves in a short time.

* A condition called phlebitis, which manifests itself with redness and tenderness on the skin along the vein line, may develop. Phlebitis completely resolves within 3-7 days with painkillers and cold application.
* Sometimes temporary bruises can be seen in the procedure area.
* The most feared complications are deep vein occlusion (DVT) and pulmonary artery embolism (Pulmonary Embolism). These are very rare, the best way to prevent them is to move early and wear appropriate compression stockings.
* Skin burns can be seen very rarely.

The procedure takes an average of 30 minutes. There are no risks of incision, scarring, bleeding and infection compared to conventional surgery. There is also less bruising and pain. Since there is no wound, there is no need for dressing.
Since there is not much pain after the procedure, there is no need to use medication. Patients
can stand up and move early.
Patients who undergo intravascular laser can return to their normal activities and work life the next day.

Laser application into the vein (EVLA) is an effective and reliable treatment method. Studies show a success rate of approximately 95%.
As a result; When performed in experienced clinics, laser is a reliable method. The patient is not hospitalized and returns to active life after a few hours.

Radiofrequency application into the veins (Endovenous radiofrequency ablation) was first used in 2007 as an alternative to the classical surgical treatment that has been used in the treatment of varicose veins. The procedure is based on the principle of entering the varicose vein with the help of doppler ultrasound and completely closing the vein with the heat energy generated by radio waves.


The procedure is performed in a sterile environment. It can be performed under general anesthesia or completely local anesthesia. However, if there is no special condition, the procedure is usually performed with local anesthesia and sedation. That is; the patient is not given general anesthesia or lumbar anesthesia. Local anesthesia and sedatives are administered to relieve tension. With the help of a small needle, the vein is entered into the vein with the help of ultrasound from the area previously anesthetized with local anesthetic. With the help of a thin guide wire sent through the needle puncture, the radiofrequency catheter is guided to the leaking area under the guidance of doppler ultrasound. A pre-prepared solution known as “tumescent anesthesia” is then administered around the vein. The purpose of this is to protect the tissues against the heat energy released and to prevent nerve damage.

After the catheter is shown to be in the safe zone again by ultrasonography, a maximum of 120 degrees of heat is delivered to the vein wall for 15 seconds with the help of a generator. After each 15-second application, the catheter is withdrawn until the next section is marked on it. Thus, uninterrupted ablation treatment is applied along the length of the varicose vein.


Compression stockings (compression stockings) or elastic bandages are applied immediately after the procedure. Compression stockings are very important to reduce bruising and leg tenderness after the procedure. Regular walks are strongly recommended in the early period, starting immediately after the procedure. Daily activities can be continued easily. Heavy exercise and weight lifting are not recommended for at least 3 months.


The rate of complications due to radiofrequency is quite low. The most common conditions are bruising, tenderness or loss of sensation in the application area, skin burn due to heat, superficial thrombophlebitis. The rates of deep vein thrombosis (DVT) and/or pulmonary artery embolism (pulmonary embolism), which are the worst complications, are very low. The most effective method to prevent the risk of deep vein thrombosis is regular walking in the early post-procedure period.


Especially in the great saphenous veins between the ankle and groin and the small saphenous veins between the heel and the back of the knee, the flow, which is normally from bottom to top, starts to flow from top to bottom, that is, in the opposite direction, when the valves in these veins deteriorate, and this eventually leads to varicose veins. The general aim of varicose vein treatments is to eliminate these leaking veins. In the past, these veins were tied, cut and removed with open surgery, while today they are closed with laser, radiofrequency and biological adhesives known as glue. In this article, we will examine the varicose vein closure method known as glue, gum or biological glue.


This substance is a special adhesive with medical uses. It has been used for many years in many vein treatments. In recent years, it has been used in the treatment of varicose veins. In this method, also called polymerization; the medical adhesive used causes a rapid reaction called polymerization in the vein, causing the vein to close and dry, and in this way, varicose veins fade and disappear over time.

In fact, laser, radiofrequency, steam or glue methods, known as closed surgeries in the treatment of varicose veins, have similar features in terms of application. In all procedures, the vein is entered into the vein with local anesthesia under ultrasound guidance and the vein is closed from the inside.

The procedure is not an operation and you can return home immediately after the procedure. In this technique, a catheter is inserted into the vein with ultrasound. The glue catheter is advanced to the junction where the leak is located. This is the groin area for the great saphenous vein and behind the knee for the small saphenous vein. From these points, the glue is squeezed into the vein, pressed with the ultrasonography probe and waited for a while for the vein to stick on itself. Then the catheter is pulled back a little and the procedure is repeated again. This is repeated along the entire vessel to be closed and the catheter is withdrawn and exited. The vein sticks to itself with adhesive along its length. The patient is awake during this whole procedure. No anesthesia other than local anesthesia is required for the needle hole where the catheter enters.


Since adhesion occurs during the procedure, it is not necessary to wear compression stockings for this part after the operation. The patient can walk immediately after the operation and return to his/her daily life. The biggest advantage of this procedure is that there is no risk of burns as in laser and radiofrequency treatments and anesthesia are not required.

As there is no risk of the procedure, no serious complications are expected afterwards. Only in the treated area, if the vein is close to the skin, there may be an increase in temperature, redness, pain and a feeling of tension. These problems are usually resolved within 3-4 days.


It is possible to be treated with one of three different methods applied through the skin surface.

-Sclerotherapy; is done with the help of a specially prepared liquid or foam needle.

-It is done with radiofrequency (RF) probes.

-It is done with laser probes.

All treatments are performed with local anesthesia, the patient starts walking immediately after the operation and continues his daily life.