Varicose veins have been documented for thousands of years and methods of treating them go back just as far.

Early treatments included surgical procedures that were profoundly painful without anesthesia and carried a high risk of complications like gangrene. Fortunately, vein treatments have come a long way since those very early procedures, offering much more comfort and safety today. Even in the past 10 years, the evolution of vein treatments has accelerated, giving sufferers more options than ever before.

Vein Stripping: Surgery for Vein Removal Surgery for varicose veins became quite popular in the 20th century as physicians discovered removal of the diseased veins offered the best prognosis for most patients. Surgical vein stripping and ligation involves either the complete removal of the vein (stripping) or tying off the vein so it can no longer function (ligation).

The great saphenous vein (GSV), the long vein that extends from anklebone to the inside of the thigh, is frequently the vein addressed during ligation and stripping. The procedure is usually performed in a hospital setting using general anesthesia. Recovery from the procedure can be uncomfortable and longer than most patients would like. Patients were also unhappy with the significant amount of scarring vein stripping also left behind much of the time.

Despite the concerns, surgical vein stripping and ligation was considered the top method for treating large varicose veins until the end of the 20th century when a less invasive treatment known as endovenous laser therapy or EVLT was introduced.

The Arrival of EVLT

Endovenous laser ablation, a procedure first introduced in 1999, completely changed the scope of varicose vein treatment. This procedure introduced the use of targeted laser energy, delivered directly into the diseased vein, to seal the vein closed. Instead of actually removing the vessel from the body, this procedure collapsed the vein inside the vein so it could be reabsorbed through the body’s natural elimination processes. As the vein disappeared, blood rerouted to healthy veins nearby.

EVLT could be performed as an outpatient procedure in the physician’s office, rather than a hospital. The laser energy was delivered via a narrow fiber inserted directly into the vessel using a micro-incision. This tiny incision did not require any suturing and left almost no visible scarring behind. Patients could easily endure the procedure using local anesthesia, which eliminated the risks associated with general anesthesia and significantly shortened the patient’s recovery period.

Studies showed EVLT to be an effective method of varicose vein treatment with a relatively low recurrence rate. However, it was some time before EVLT and other treatments basically took the place completely of surgical procedures.

Sclerotherapy: A Time-Tested Technique

Like surgical vein stripping, sclerotherapy boasts a long history of treating smaller, superficial varicose and spider veins. This procedure was first introduced in the 19th century, although the high risk of gangrene and other complications prevented the procedure from being used extensively until a few decades later. By the 1930s, sclerotherapy was becoming a more common way to treat visible veins, with increasing success as the technique continued to improve.

Sclerotherapy is an injectable treatment that involves the administration of a sterile solution directly into the affected vessel. This solution irritates the lining of the vessel, sealing it closed so it collapses and eventually fades from view. As the treated vessel is reabsorbed by the body, blood is rerouted through healthy veins nearby.

Sclerotherapy has been considered the “gold standard” in spider vein treatment for many years. Today, the introduction of thicker sclerosing agents and ultrasound guidance to locate deeper vessels has allowed this procedure to be used in a broader range of procedures. Patients often require more than one treatment session of sclerotherapy to achieve full results. However, the ease of the treatment continues to make this a top recommended procedure for many patients today.

Today’s Minimally-Invasive Treatment Options

With the success of EVLT, other treatments have also come on the vein treatment scene in recent years. At Vein Specialists of the Carolinas, we offer a full menu of the latest vein treatments, including sclerotherapy and the following procedures:

VNUS Closure

Also known as Venefit, this procedure works in a similar fashion to EVLT. However, radiofrequency energy is delivered into the vessel instead of lasers, giving patients even more comfortable, satisfying results. This procedure is performed in our office on an outpatient basis using local anesthesia to ensure your comfort throughout. Venefit takes approximately 45-60 minutes to complete and patients are usually back to their regular activities the next day.

VNUS Closure is an effective procedure for treating varicose veins and is covered by most insurance companies. Studies have shown this treatment has a 98-percent patient satisfaction rate. In addition, 90 percent of treated vessels remain closed and reflux-free long after the procedure. Patients also find that uncomfortable symptoms that accompanied their varicose veins, such as leg heaviness, cramping and swelling are also relieved after the procedure.


Microphlebectomy is a much less invasive procedure than vein stripping and may be recommended to remove large, tortuous veins from the lower leg. This procedure uses micro-incisions and a special tool to remove larger varicose veins from the leg in small sections. The incisions are too small to require sutures and leave little or no scarring afterward. The procedure can be performed on an outpatient basis using local anesthesia and most patients are back to regular activities within a day.

Microphlebectomy also boasts a high patient satisfaction rate with a low incidence of recurrence after the procedure. Patients find their symptoms improve quickly as well, sometimes as soon as the day after treatment. This procedure has replaced more invasive surgical procedures for nearly all patients today.

If you are suffering the pain and embarrassment of varicose veins, don’t let fear over the treatment keep you from getting the relief you need. At Vein Specialists of the Carolinas, we will work with you to determine the best procedure for your specific needs. No matter which procedure you have, you will experience little or no discomfort from your procedures and you will be back to your daily activities almost immediately.

To learn more, contact Vein Specialists of the Carolinas today at 704-861-2072 or 704-544-5245 .


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