Endovenous Laser Therapy – Application Studies, Clinical Update, and Innovative Developments

Abstract

Endovenous laser therapy (ELT) was introduced in clinical practice as a therapy for incompetent veins about 10 years ago. One characteristic of ELT is the broad spectrum of different treatment protocols by means of a variety of laser systems together with manifold application forms. A variety of light dosimetric concepts are under investigation. Endoluminal laser treatment of incompetent great saphenous veins of patients suffering from varicosis is a promising new procedure offering fewer side effects than conventional surgical stripping methods. Clinical results with effective, relatively pain‐free occlusion of incompetent varicose veins have been observed, and also undesired side effects such as ecchymosis, phlebitis, and recanalization. In recent years, systematic experimental investigations and the analysis of clinical results have increased the understanding of the interrelation between the clinical and physical aspects, followed by continuous optimization of ELT. The use of infrared wavelengths and radial irradiation concepts, together with continuous moving of the optical fiber, seems to reduce possible side effects. In this way, ELT treatment becomes a more standardized effective method for the treatment of varicose veins. In future, randomized controlled studies are required to compare optimized ELT treatment with other endoluminal modalities and conventional surgery.