Laser Treatment vs. Traditional Surgery for Varicose Veins: Understanding the Key Differences and Patient Guidance

Laser Treatment vs. Traditional Surgery for Varicose Veins

Varicose veins affect an estimated 3.7 million Canadians, often leading to aching, swelling, and skin changes if left untreated. Understanding the differences between laser treatment and traditional surgery for varicose veins empowers you to select an option that balances invasiveness, recovery, effectiveness, and long-term relief. In this guide, you’ll learn what causes varicose veins, how vein stripping and endovenous laser therapy (EVLT) work, a detailed side-by-side comparison, recovery expectations, and the factors that influence treatment choice. You’ll also discover why Dr. Luis Figueroa’s minimally invasive approach at Ontario Vascular can offer faster healing and superior cosmetic outcomes.

What Are Varicose Veins and Why Is Treatment Important?

Varicose veins are enlarged, twisted superficial leg veins that develop when faulty valves allow blood to pool against gravity, causing discomfort and potential complications. Treating varicose veins restores healthy circulation, alleviates symptoms, and prevents skin ulcers or blood clots. Early intervention can significantly improve your quality of life and minimize long-term risks.

What Causes Varicose Veins and Who Is at Risk?

Faulty venous valves struggle to propel blood upward, leading to pressure buildup and vein dilation.

Key risk factors include:

• Age and genetics: Weakened valves often have a hereditary component.

• Hormonal changes: Pregnancy and menopause can affect vascular tone.

• Lifestyle: Prolonged standing or excess weight can increase venous pressure.

Valve dysfunction and elevated pressure explain the higher incidence in women over 50 and individuals whose occupations require extended periods of standing. Recognizing these risk factors helps us identify the signs that warrant medical attention.

What Symptoms Indicate the Need for Treatment?

Visible bulging veins can signify more than just a cosmetic concern. Common warning signs include:

• Leg ache or heaviness after standing

• Swelling in the ankles and feet

• Skin discoloration or itchiness near the veins

Persistent pain or restless legs may indicate valve incompetence that requires evaluation, guiding us toward considering tailored interventions.

When Should You Consider Medical Treatment for Varicose Veins?

If your symptoms interfere with daily activities or if skin changes begin to emerge, a medical evaluation is recommended. You should seek a consultation when:

• Discomfort persists despite lifestyle adjustments

• Complications such as eczema or ulcers develop

• You desire definitive relief rather than temporary solutions

Early assessment by a vascular specialist ensures timely treatment planning and optimal results.

What Is Traditional Varicose Vein Surgery and How Does It Work?

Traditional surgery, known as vein stripping and ligation, involves tying off and removing malfunctioning veins through incisions, thereby redirecting blood flow to healthier veins.

What Does Vein Stripping and Ligation Involve?

Vein stripping removes the saphenous vein through two small incisions—one at the groin and another near the knee or ankle. Performed under general or spinal anesthesia:

1. A specialized wire is carefully threaded through the vein.

2. The vein is tied off (ligated) at its origin.

3. The wire is then used to “strip” the vessel out.

Patients typically stay overnight in the hospital before being discharged. This surgical approach directly eliminates the problematic veins, setting the stage for the recovery process.

What Are the Benefits and Risks of Traditional Surgery?

Here’s an overview of the outcomes and considerations associated with vein stripping.

Key Benefits and Risks

• Definitive vein removal can reduce recurrence in cases of significant reflux patterns

• Long track record with well-established technical success

• Potential risks: infection, nerve injury, scarring, blood clots

Despite its proven effectiveness, the invasiveness and longer recovery period associated with traditional surgery have led to the development of less invasive alternatives.

Who Is a Good Candidate for Traditional Vein Surgery?

Surgical vein stripping is often suitable for patients with:

• Extensive reflux in large superficial veins

• Lack of response to less invasive treatments

• Good overall health status for general anesthesia

Understanding these criteria helps align surgical indications with individual health profiles.

Laser Treatment

How Does Endovenous Laser Treatment (EVLT) Work for Varicose Veins?

Endovenous laser treatment (EVLT) is a minimally invasive procedure that utilizes laser energy to close diseased veins from the inside, guided by ultrasound.

What Is the EVLT Procedure and How Is It Performed?

EVLT combines heat and light to seal leaking veins without the need for open incisions. During a typical session:

1. Local anesthesia is administered to numb the treatment area.

2. An ultrasound probe is used to precisely locate the faulty vein.

3. A thin laser fiber is inserted through a small needle puncture.

4. Laser energy is delivered as the fiber is slowly withdrawn, causing the vein wall to collapse and seal.

Patients are able to walk immediately after the 30–60 minute treatment, facilitating a rapid return to their normal activities.

What Are the Advantages and Potential Side Effects of EVLT?

EVLT offers several advantages over traditional surgery:

• Minimal invasiveness with no large incisions required

• Local anesthesia avoids the risks associated with general or spinal anesthesia

• Faster recovery allows for a quicker resumption of daily activities

Potential side effects may include bruising, temporary numbness, or mild skin discoloration, which typically resolve on their own.

Who Should Consider Laser Treatment for Varicose Veins?

Ideal candidates for EVLT typically have:

• Moderate to severe reflux in the great or small saphenous veins

• A desire for rapid healing and minimal scarring

• Contraindications for general anesthesia

Laser therapy is an excellent choice for patients who prefer less invasive approaches without compromising on effectiveness.

What Are the Key Differences Between Laser Treatment and Traditional Surgery?

A clear comparison highlights how EVLT and vein stripping differ across essential aspects.

Treatment Method	Procedure Type	Anesthesia	Recovery Time	Pain Level	Scarring	Success Rate	Recurrence Risk	Cost Considerations
Vein Stripping & Ligation	Surgical removal	General/Spinal	2–4 weeks	Moderate to high	Visible incisions	~95% technical	Slightly lower	Higher inpatient costs, OHIP covers surgery
Endovenous Laser Treatment (EVLT)	Thermal ablation	Local	1–3 days	Low to moderate	Minimal puncture site	~94% clinical	Comparable long-term	Outpatient procedure, OHIP covers consultation

How Do Invasiveness and Anesthesia Compare?

EVLT is a percutaneous, heat-based closure performed under local anesthesia, whereas vein stripping involves incisions and general or spinal anesthesia. The less invasive nature of EVLT leads to reduced procedural risk and a shorter hospital stay.

What Are the Differences in Recovery Time and Pain Levels?

Following EVLT, most patients can resume normal activities within 1–3 days with minimal discomfort. Traditional surgery often requires a 2–4 week convalescence period with a greater need for pain medication.

How Do Success Rates and Recurrence Risks Differ?

Success Rates and Recurrence Risks

Clinical studies indicate similar closure rates for EVLT (approximately 94%) and surgical stripping (approximately 95%), with only minor differences in two-year technical success. Both methods demonstrate low long-term recurrence when performed by experienced specialists.

This underscores that both EVLT and traditional surgery achieve high success rates, with comparable long-term recurrence risks.

What Are the Cost Considerations and Insurance Coverage in Ontario?

OHIP Coverage for Varicose Vein Treatments in Ontario

Under Ontario’s OHIP system, surgical vein stripping and the initial consultation for EVLT are covered. Out-of-pocket expenses might apply for consumables or advanced laser equipment, but EVLT often reduces overall costs by avoiding hospitalization.

This clarifies the cost considerations and insurance coverage for both surgical and laser treatments in Ontario.

How Does Scarring and Cosmetic Outcome Compare?

Laser ablation requires only needle-size entry points that heal without noticeable scars, whereas surgery leaves linear incisions that may be visible. Patients prioritizing cosmetic results often prefer EVLT due to its minimal scarring.

What Should Patients Expect During Recovery and Aftercare?

Recovery protocols differ between EVLT and traditional surgery but share fundamental principles of compression and gradual activity progression.

How Does Recovery Differ Between Laser Treatment and Surgery?

Here’s a comparison of typical recovery timelines.

Procedure	Activity Resumption	Compression Duration	Follow-up Visits
EVLT	Walk immediately, return to work in 1–3 days	1–2 weeks	1 week, 1 month
Vein Stripping & Ligation	Light activity in 1 week, work in 2–4 weeks	2–4 weeks	1 week, 4 weeks

Key Differences in Recovery Time

Following endovenous laser treatment (EVLT), most patients can resume normal activities within 1–3 days with minimal discomfort. In contrast, traditional surgery often necessitates a 2–4 week recovery period with a greater need for pain relief.

This highlights the significant difference in recovery time between EVLT and traditional surgery, a crucial factor for many patients.

What Are the Recommended Aftercare Practices for Each Procedure?

Consistent use of medical-grade compression stockings, elevating your legs several times daily, and avoiding heavy lifting will help accelerate healing. Pain management may involve over-the-counter or prescription analgesics, as directed by your physician.

When Should Patients Seek Medical Advice During Recovery?

Contact your vascular surgeon if you experience:

• Sudden calf pain or swelling

• Signs of infection (e.g., redness, fever)

• Unusual bleeding or severe numbness

Early detection of any complications ensures prompt treatment and helps maintain the success of the procedure.

How Can You Make an Informed Decision Between Laser Treatment and Surgery?

Choosing the right therapy depends on your vein characteristics, overall health, and personal priorities.

What Factors Influence the Choice of Treatment?

Key considerations include:

• Vein size and anatomy: Larger, more tortuous veins might be better suited for surgery.

• Severity of reflux: Widespread reflux can often be managed with EVLT combined with additional therapies.

• Overall health: Patients who are not candidates for general anesthesia often benefit from laser treatment under local anesthesia.

Carefully evaluating these factors helps shape a personalized treatment plan.

Why Is Specialist Consultation Important?

A vascular surgeon will perform a comprehensive duplex ultrasound to map your reflux patterns, correlating your symptoms with your venous anatomy. Dr. Luis Figueroa’s expertise ensures an accurate diagnosis and the selection of the most appropriate procedure for your specific needs.

How Do Patient Preferences and Lifestyle Impact Treatment Selection?

Active lifestyles and cosmetic concerns often lead patients to prefer EVLT. Conversely, individuals with complex vein networks or those who have had previous unsuccessful ablations might opt for surgical stripping. Shared decision-making between you and your specialist ensures satisfaction and adherence to the treatment plan.

Why Choose Ontario Vascular and Dr. Luis Figueroa for Varicose Vein Treatment?

Ontario Vascular, under the leadership of board-certified vascular surgeon Dr. Luis Figueroa, combines advanced techniques with compassionate, patient-centred care. By focusing on minimally invasive therapies, the clinic delivers high-quality outcomes and a streamlined recovery experience.

What Expertise Does Dr. Luis Figueroa Bring to Varicose Vein Care?

Dr. Luis Figueroa: Toronto Vascular Surgeon.

Dr. Luis Figueroa's Expertise

Dr. Luis Figueroa, a board-certified vascular surgeon, blends advanced techniques with compassionate, patient-first care. He holds credentials from McMaster University and the University of Toronto, bringing over a decade of specialized vascular surgery experience.

This highlights Dr. Figueroa's qualifications and extensive experience in the field of vascular surgery.

What Minimally Invasive Treatments Does Ontario Vascular Offer?

In addition to EVLT, the clinic offers ultrasound-guided sclerotherapy, radiofrequency ablation, and glue embolization—each tailored to specific vein anatomies to ensure optimal closure and patient comfort.

How Does Ontario Vascular Support Patients Through Treatment?

Our bilingual care team (English/Spanish) guides patients from their initial ultrasound consultation through their follow-up appointments, providing OHIP-covered assessments, clear educational materials, and personalized recovery plans.

What Are the Most Frequently Asked Questions

About Laser Treatment vs. Surgery?

Which Is Better: Laser Treatment or Surgery for Varicose Veins?

EVLT is generally favored for its minimally invasive nature, quicker recovery, and excellent cosmetic results. However, traditional surgery remains a robust option for extensive or complex reflux patterns.

How Long Is Recovery After Each Treatment?

Most EVLT patients can return to work within 1–3 days, while vein stripping typically requires 2–4 weeks of gradual convalescence, depending on your activity levels.

Is Laser Treatment Permanent and What Are the Recurrence Rates?

Laser ablation provides permanent closure of the treated veins. Long-term recurrence rates are comparable to surgery, particularly when combined with adjunctive therapies for any remaining branches.

How Painful Are Laser Treatment and Surgery?

Pain from EVLT is usually mild and short-lived, manageable with over-the-counter pain relievers. Surgical patients often report moderate pain that may require prescription analgesics for several days.

What Are the Costs and Is Treatment Covered by OHIP?

Both surgical vein stripping and the initial EVLT consultation are covered by OHIP. Minor out-of-pocket expenses may apply for specialized laser fibers or complementary treatments.

Varicose vein treatment options range from time-tested surgery to advanced laser ablation, each offering distinct advantages. With a detailed duplex map and expert evaluation, you can collaborate with a vascular surgeon to choose the option that best suits your anatomy, lifestyle, and recovery goals. Dr. Luis Figueroa and the Ontario Vascular team specialize in endovenous techniques to provide effective relief with minimal downtime. Take the first step toward healthier legs by scheduling your OHIP-covered vein consultation today.