Laser Vein Treatment for "broken" veins

Three leg procedures down; 3 still to go, possibly 4. The next two are only 2 days apart: the final perforator on a Tuesday and the greater saphenous vein two days later, on Thursday. They tell me that one will probably be “pretty uncomfortable.”

The first 4 procedures consist of laser obliteration of 4 perforator veins (called that because they perforate the fascia – go through it). There are 140 tiny perforator veins in each leg, all of which are supposed to be the size of capillaries. Their job is to carry blood from the superficial veins to the deep venous system which returns that “used” blood to the heart for oxygenation, making it ready for the round trip through the body again. My 4 “broken” perforator veins are/were 5/16″ in size (that’s almost 1/2 inch in diameter!) and have been responsible for keeping blood pooled in the ankle area. This pooling caused lots of swelling, sometimes to 3 or 4 times normal ankle size, and also caused ulcers that took from several months to over a year to heal. Three of those are now GONE! Just one more of those, and then the big ones.

For the greater saphenous vein procedure, the needle carrying the fiberoptic laser (size 14 needle!) is inserted into the vein at the back of the knee and threaded up to the groin. Obviously, a fair amount of novocaine with it! Then he turns on the laser (1000 degrees) and starts pulling the fiber/laser back toward the knee, essentially boiling the blood into steam and obliterating the vein. Two weeks later, they do an ultrasound to see if the lower part of that vein (that goes from knee to ankle) has closed itself. Apparently 4/5 times, it closes by itself. If not, then they have to go in and take care of that one as well.

Following the greater saphenous procedure, the leg is wrapped (tightly) from groin to ankle for 48 hours, then I can remove that dressing and “only” have to wear a thigh-high compression sock for – Yikes! – two weeks.

After that, once they’ve done the ultrasound and verified the lower portion of that vein has closed itself, the lesser saphenous gets the same treatment. That vein goes from knee to ankle only, though, so at least I can go back to just my regular knee-high compression socks for two weeks after that procedure – and then I’m done!

The first one was a walk in the park. The last two have been fairly uncomfortable, but the end result will be NO MORE COMPRESSION SOCKS! And no more swelling in the ankle, and no more open ulcers because of circulation issues. Woohoo!!

This problem has been going on for 39 years, ever since a motorcycle accident, so you can probably imagine my degree of amazement (that it can even be done), excitement as the ankle gets progressively “unswollen” – even after 3 hours on my feet on dart night, and the relief of not having to worry about an ankle ulcer happening anymore. Wow. Modern medicine has some real miracles with it.

Dr. Joyce (Joyce Vein & Aesthetic Institute here in Punta Gorda, FL) is considered the leader in this type of procedure. He has done over 1000 cases since the laser treatment was introduced – with HUGE success rates. He will be delivering a paper on it in early November to the American College of Phlebology. (


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