Varicose Veins India
Endovenous Laser and Radiofrequency Treatment of Leg Veins
- Ankle edema
- Leg fatigue
- Muscle cramps
Some patients develop associated complications including
- Stasis dermatitis
- Skin atrophy
- Superficial thrombophlebitis
- Venous ulcers
The treatment of varicose veins reduces symptoms and complications of chronic venous insufficiency and improves quality of life. Superficial varicose veins are often due to failure of the valves in the saphenous vein and at the saphenofemoral junction, causing venous reflux. Until recently, traditional ligation and stripping has been the standard of care in the treatment of truncal varicosities. But there are some disadvantages, including a 20% recurrence rate in 5 years, requirement of 2-6 weeks of downtime, associated risks of general anesthesia, scars and possible neurovascular and lymphatic vessel damage. As an alternative, there are currently available endovenous treatment options for superficial varicose veins, ultrasound guided foam sclerotherapy, endovenous radiofrequency and endovenous laser treatments. These are minimally invasive in office procedures with less pain, early ambulation and less recovery time.
Endovenous Laser Therapy
In January 2002, an 810-nm diode laser received Federal Drug Administration clearance for use in endovenous laser therapy.
This procedure can be done in office under local anesthesia. After vein treatment patients are able to walk immediately and most individuals are able to return work the next day. The mechanism of action is the ablation of the target vein through delivery of laser energy.
Endovenous Radiofrequency Ablation
Endovenous radiofrequency ablation was FDA approved for the treatment of the great saphenous vein in 1999. This is a minimally invasive in office treatment using local anesthesia with 1-2 days of downtime. Eighty -five percent of patients return to normal activity within 1 day. Instead of using optical fibers, VNUS technology applies RF energy directly to the vein walls through a endoluminal catheter fitted with metal electrodes at the tip.
Q: What are the advantages of Endovenous laser?
A: It has following advantages as compared to surgical techniques:
- Outpatient procedure not requiring general anaesthesia
- Minimally painful
- Marked reduction in rehabilitation time
- Excellent cosmetic result with no scarring
- Short procedure time
- Excellent clinical and aesthetic results
Q: What are the complications of Endovenous Laser treatment?
A: Complications are rare and include post operative bruising and tenderness, local infection of the skin, inflammation of the vein and very rarely pulmonary thromboembolism.
Q: What are the precaution to be taken after Endovenous Laser treatment?
A: A tight elastocrepe bandage is advised to applied to the limb after laser treatment and the patient can start walking immediately. A customized pressure garment is to be worn by the patient. The patient is advised to walk as much as possible but to restrain from heavy activities for about 15-30 days. The patient is continued on antibiotics and pain relieving drugs for few days.
Q: How does one follow up after Endovenous Laser treatment?
A: The patient is advised to follow the instructions strictly. Follow up Doppler of the treated limb is done after 7 days and 30 days to look for vein closure and the presence of venous thrombosis.