Background. Many women express their dissatisfaction with prominent and bulging hand veins. The decreased elasticity and loss of adipose tissue that occur with aging accentuate these tortuous veins. Sclerotherapy of hand veins requires the use of higher concentrations of sclerosing agents than is used for leg veins and often results in a tender phlebitic cord. Phlebectomy is another treatment option for patients with cosmetic concerns.

Objective. To demonstrate a new and unique endovenous laser technique to abolish unwanted hand veins..

Methods. Fifteen hands (eight patients) with prominent hand veins were treated using a 600 Micron Laser Fiber. The Dornier MedTech 940 nm diode Laser system was used. The laser fiber was introduced through a four french sheath, which tracked as a coaxial system over a .018 guide wire. Initial entry into the treated vein was accomplished with a 20 gauge angiocatheter percutaneously. On average, four veins were treated in each hand. Tumescent anesthesia was infiltrated around the laser fiber/ sheath unit before activating the laser and all procedures were performed in an office setting. A compressive dressing was used postoperatively. Results. All unwanted hand veins were successfully cannulated and ablated,,but one; the uncannulated vein was treated with sclerotherapy and eventually required phlebectomy.

Hand swelling occurred in all treated hands and lasted 2 weeks. There were no skin complications and specifically no skin burns. All eight patients were satisfied with their results during their follow up, which ranged from five weeks to one year.

Conclusion. This is the first report of endovenous treatment of hand veins. Laser ablation of unwanted hand veins can be performed in an office setting. These cosmetically conscious patients are satisfied with their results.
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