Vascular Surgeon

Georgios Vourliotakis MD, PhD

 

Endovascular fellowship  in University Medical Center of Groningen, Netherlands

Tel: 2177008002, Mob: 6937332302, www.aggeia.gr

Vasilissis Sofias Avenue 122, Athens, 1st Floor, 1st Office

 e-mail: gvourliotakis@aggeia.gr

Endovenous laser ablation of varicose veins

 Chronic venous disorders of lower limbs are problems caused by venous hypertension. It is created as a result of chronic valvular insufficiency of the saphenous veins and their branches. In patients with  saphenous vein insufficiency and depending on the clinical stage of vein disease, treatment should begin with the elimination of this deficiency.Until recently the best way to achieve this was the saphenous vein ligation before its junction in the deep venous system and the  excision of the saphenous vein and its branches (vein stripping). The last 10 years this method was gradually replaced by other minimally invasive, intravenous treatment methods using Laser or RFA (Radio Frequency Ablation), without the need of removal of the affected saphenous vein.

Picture 1. Combination Laser and micro venotomies      Picture 2. Ultrasound vein mapping before treatment

The endovenous Laser ablation is a bloodless surgery treatment which could be performed under local anesthesia and ultrasound guidance, with safety and accuracy, while its implementation requires very precise planning and mapping of the affected vein before surgery.From the area of ​​the tibia the optical fiber Laser is inserted trans dermal in the saphenous vein and advanced proximally, promoted head as the amount of contribution safinomiriaias. The saphenous vein is filtered around the cold solution with special local anesthetic. Depending on the diameter and length of the saphenous to be treated is calculated the amount of energy to be given during the treatment. As the fiber optic is withdrawn progressively diffuses radially energy which shrinks uniformly venous walls and seals completely vein. After closing the treated vein circulation restored through healthy veins network.

Picture 3. Ultrasound imaging of saphenofemoral junction during the Laser ablation 
Picture 4. Immediately after treatment, confirmation of vein occlusion

The total process lasts 20-30 minutes, is almost painless during and after the treatment, with no cuts or stitches, while the results are immediate. The risk of discoloration, burning, bruising or other complications is minimal especially with the new generation of optical fiber. The advantage of this method is the possibility of applying in the early stages of venous insufficiency and the simultaneous combination with other methods such as foam sclerotherapy  and micro venotomies of peripheral varicose veins.The patient in consultation with a physician can go home even the same day fully mobilized and in his previous activities in 2-3 days except exhaustive exercise.