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Varicose veins- laser therapy | Chronic venous insufficency -- conventional surgical method |
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The procedure is carried out under local anestesia, so-called tumescent anesthesia. With this technique you will retain your ability to fully move your body on the operating table and therefore can assist in case you need to change position. Also, your risk for venous thrombosis is signifcantly reduced compared to general anesthesia. This method is specially suited for patients with coronary heart disease or asthma, as general anesthesia bears specific risks for those patients.
The vein that is to be treated, is punctured on the lower leg (similar to a phlebotomy for blood taking); cuts with a scalpell are usually not required. A flexible fiberoptic catheter is inserted into the vein (ultrasound controlled) and the laser beam is thus transmitted to the inner wall of the vein. Subsequently, the laser is positioned at the junction of the varicose vein with the deep vein. Within a few minutes, the fiberoptic cable is slowly being removed while the laser energy is released into the wall of the vein. The place where the catheter was inserted is taped and a pressure dressing is applied for one day. After the first change of bandages, a compression stocking has to be worn for 1 week during the day as well as at night. for 10 days, starting at the day of the operation, heparin injections are administered as prophylaxis against thrombosis.
Current experience with this method and risks
Bisherige Erfahrungen mit der Methode, Risiken
So far, in the US and in Europe several thousand patients have been treated by endoluminal laser therapy, as described above. Short- and medium term results do not differ significantly from the conventional surgical methods (crossectomy and stripping). In rare cases (below 1%), the closure of the vein is not successful. In this case a repeated laser treatment or surgical intervention is necessary. So far, no long-term results exist, therefore a small chance remains that future surgical intervention might become necessary. However, it needs to be considered that even when the conventional surgical method is carried out, up to 20% of the patients may require another operation. Treatment costs are 925€ for patients with state health insurance, while private patients receive a bill according to the billing manual of doctors.
Undesired side effects and complications
As every surgical procedure, also this method bears risk that cannot be ruled out even when the greatest care and prudence is being taken. Statistically speaking, these risks are rare. They involve the following:
Should the laser treatment result in only partial obliteration of the vein or fail to do so completely, a switch at the time of treatment to conventional surgical methods (crossectomy and stripping) can be performed.
-Advantages of the endoluminal laser therapy