LASER

ANESTHESIA is local, most often localized in the crural area (one leg only)

HOSPITALIZATION : day surgery  (in and out)

TECHNIQUE

Under echography

Punction of the saphen vein

A 1.2mm catheter is introduced into the saphenous varicose vein

This catheter makes way for an optical fiber (400 to 600 µm in diameter) which will deliver energy at its end in the form of a laser.

This optic fiber is connected to a laser generator

Water is injected around the blood vessel to protect it

It emits light at a specific wavelength (980 nm or more)

The light energy is absorbed by a target molecule (chromophore) in the blood called oxyhemoglobine.

Sclerosis of the inside wall of the saphenous vein (endovein) using laser photocoagulation

This will allow for a complete shriveling of the diseased vessel. The flow of blood is then stopped.

At later time, the body will slowly resorb the vessel.

It will sometimes be necessary to surgically perform phlebectomy to achieve a complete, proper healing.

AFTER THE PROCEDURE

In the following days a shrinking of the diseased vessel is noticeable.

The vein may be slightly inflamed and hardened.

Very few hematomas would be present compared to the classic stripping method.

ADVANTAGES

Highly impermeable

No or almost unnoticeable scaring (in case of additional phlebectomies)

Leave of absence is reduced by a factor of three compared to classic surgery

No or rare post-operative pain.

Much lower cost (anesthesia, surgery, leave of absence)

Only the diseased vessels are treated preserving the healthy ones.

Those advantages are useful for treating a wider range of people (vulnerable people like the elderly) who could not benefit from classic surgery but who were still at risk for thrombosis.

Diseased vessels up to 20mm in diameter are treatable.

ADVERSE EFFECTS 

Allergic reaction to local anesthetics

Burns are possible with a thin patient

Reversible darkening of the skin marking the path of the vessel if localized close to the skin

Fleeting pains manageable with over-the-counter painkillers

Deep or superficial vein thrombosis

Paresthesia (tingling sensation, numbness)