Laser Treatment of Varicose Veins: Order Out of Chaos

Varicose Vein: Current Management

“…Circumferential compression dressings are placed on the affected limb from the ankle to the groin for the next several days. The activity limitations are similar to those in the RFA-treated patients [18,20].…”

“…There are several different companies that supply a variety of laser generators. The available wavelengths for treatment range from 810 nm to 1470 nm [18]. Most recently, there is report of a 1500-nm wavelength laser generator that, similar to other higherwavelength devices, should preferentially allow absorption by the water molecules in the vein wall cells rather than by blood [19].…”

“…Avoidance of this area and liberal use of tumescent anesthesia can help protect from nerve injury. Superficial thrombophlebitis occurs between 1% and 12% of the cases and is most commonly managed with nonsteroidal medication, compression, and ambulation [18][19][20][21][22].…”

“…Similar to RFA, it is important to empty the vein segment being treated of blood by placing the patient in the Trendelenburg position. Although heated blood has been suggested to result in the homogenous distribution of thermal injury, the presence of blood within the segment being treated may actually prevent the generation of adequate levels of injury to the vein wall [18,20,21].…”

“…Relative contraindications may include the inability to traverse the vein segment (tortuosity and prior treatment), ineffective treatment (large vein diameter), and increased risk of DVT (hormone replacement therapy [HRT]). Anticoagulation therapy may increase the risk of vein recanalization [18,20,21]. The mechanism of action of endovenous laser therapy involves causing thermal injury to the vein wall endothelium.…”