Endovenous Laser Ablation and Sclerotherapy for Treatment of Varicose Veins

Abstract

Superficial venous insufficiency is a common problem associated with varicose veins. Venous insufficiency and varicose veins can be symptomatic, but more commonly they are a cosmetic concern. In this article, we discuss the relevant anatomy and pathophysiology of superficial venous insufficiency, review the current literature for varicose vein treatment, and cover the technical aspects of diagnosing and treating superficial venous insufficiency. Saphenofemoral junction incompetence with resultant greater saphenous vein reflux is the most common cause of varicose veins; because this condition constitutes the majority of patients encountered in practice, we will concentrate on this area. Endovenous laser ablation and sclerotherapy are covered, including patient workup and selection, procedure set-up, and anesthesia.

Vascular sclerosing effects of bleomycin on cutaneous veins: a pharmacopathologic study on experimental animals

“…Some people may be more likely than others to develop VVs because of inherited characteristics (genetic etiology), obesity, pregnancy, intra-abdominal malignancy and aging process. 20 …”

Endovenous laser ablation and foam sclerotherapy for varicose veins: does the presence of perforating vein insufficiency affect the treatment outcome?

“…Complications of surgical therapy include neurosensory loss (4 -25%), wound infection (2 -15%), hematoma (30%), and deep venous thrombosis (,2%). Recurrences are as high as 21 -37% at 5 years post surgery (3,16,17). Less invasive endovascular methods (radiofrequency ablation [RFA] and EVLA) have been developed as alternatives to surgery, with the intention of reducing morbidity and recovery time (3,(18)(19)(20)(21)(22)(23).…”

“…Recurrences are as high as 21 -37% at 5 years post surgery (3,16,17). Less invasive endovascular methods (radiofrequency ablation [RFA] and EVLA) have been developed as alternatives to surgery, with the intention of reducing morbidity and recovery time (3,(18)(19)(20)(21)(22)(23). EVLA has been shown to be at least equivalent to saphenofemoral ligation and stripping with decreased recovery time and periprocedural morbidity (2,21,24).…”

A rare complication of endovenous laser ablation: intravascular laser catheter breakage

“…Nowadays, vein stripping is not performed routinely and supplemented by an endovenous laser ablation (EVLA) of varicose veins secondary to saphenofemoral junction (SFJ) insufficiency 3. Recently, EVLA, radiofrequency ablation (RFA) and foam sclerotherapy are being used as alternatives to surgery in the treatment of superficial venous insufficiency 4. Among these minimally invasive methods with low complication rates, EVLA, in particular, is the most current method.…”