Varicose veins are very common. For years the most commonly applied treatment for great saphenous vein (GSV) insufficiency was saphenofemoral junction
ligation with saphenous vein stripping. Minimally invasive methods, such as the endovenous
laser therapy, are increasingly used during the last few years. In endovenous
laser therapy, a
diode laser fibre is inserted percutaneously into the GSV using ultrasonography to confirm the position. Thermal
laser energy is applied to the endothelium ofthe GSV, resulting in local venous occlusion. The procedure has rapidly become popular with clinicians who treat
varicose veins due to its relative simplicity and high rate of patient satisfaction. Efficacy outcomes are good with an occlusion rate of up to 100%. Recanalisation is rarely occurring even after several years.
Pain, haematoma and
phlebitis are common adverse events associated with endovenous
laser therapy but in most cases are self-limiting. Serious adverse events, such as
deep vein thrombosis, are uncommon. The advantages ofendovenous
laser therapy are the lack of
surgical wounds, so
infection and
scarring are avoided, and that the procedure can be performed in an outpatient setting using local anaesthesia. Endovenous
laser therapy appears to be a safe and effective treatment option for refluxing
varicose veins.