Veins are obliterated by heat applied in the lumen
Laser light applied to the inside of the veins (endoluminal) is used to obliterate the region of the saphenous vein that is affected by varicose vein disease. The vein dies off and is then broken down by the body. Since the German statutory health insurers usually only reimburse the costs for classic vein stripping, patients must pay for laser therapy themselves.
Who is laser therapy suitable for?
In principle, almost all patients suffering from varicose saphenous veins can have laser therapy. As with vein stripping, the saphenous vein can only be removed by laser therapy, if the deep venous system is healthy. This is checked before treatment, for example, by an ultrasound examination (Doppler ultrasonography). Since no incisions are necessary for laser therapy and there are thus no lasting scars, the procedure is most suitable for patients, who attach great importance to the cosmetic outcome.
How varicose veins are treated by endoluminal laser therapy
A hollow needle is inserted in the affected saphenous vein - like when taking a blood sample - above the knee or at the ankle. The attending doctor advances the light-conducting laser fibre along the vein to the start of the affected segment under ultrasonographic guidance. The laser energy emitted by the tip of the fibre heats (coagulates) the blood and the venous wall. This obliterates the vein. The whole of the affected vein segment is treated as the laser fibre is slowly withdrawn.
Laser therapy is given under local anaesthesia. For this, the doctor injects a special anaesthetic into the fatty tissues under the skin around the affected vein. During laser therapy, this solution ensures that
- the patients feel no pain apart, perhaps, from a feeling of warmth,
- the vein is squeezed, thus allowing the laser energy to reach the vein walls better,
- the surrounding tissues are protected against overheating by the laser energy,
- the surrounding tissues do not become inflamed.
After laser therapy
After the treatment, which is mostly performed as an outpatient procedure, patients wear a compression stocking for around four weeks. The doctor checks the treatment outcome at the follow-up examinations. Possible side effects of the procedure that usually disappear after a short time or can be prevented by compression stockings might be:
- Injuries of nerves, vessels and neighbouring organs
- Sensory disorders
- Pooling of lymph fluid
Complications are rarer, they may include
- Severe pain
- Wound healing disorders
- Hypersensitivity reactions to the anaesthetic
Venous insufficiency itself cannot be cured by surgery for varicose veins. Therefore, patients should continue to wear their compression garments every day after successful vein surgery to prevent the onset of new varicose veins and enjoy the outcome of the operation for years to come.
Compression stockings from medi
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