Endovenous treatment is currently one of the most frequently used methods for treating varicose veins . Varicose veins are tortuous and enlarged veins due to
weakening in the vein’s wall or valves. They are manifestations of chronic venous disease(CVD), which may lead to serious complications.
It can treat spider veins and tiny varicose veins just under the skin’s surface. Usually, more than one laser session is needed. . If you have poor blood circulation feeding these tiny veins, the larger “feeder” vein must first be treated with surgery, endovenous laser or radiofrequency treatment, or sclerotherapy.
Heating decreases with tissue depth as absorption and scattering attenuate the incident beam. Consequently, the laser beam must heat the vein wall and not the blood.
The appropriate linear endovenous energy density (LEED) must be selected as a function of the diameter of treated segment. Veins larger than 9–12 mm in diameter are difficult to treat, even when using higher energy.
EVLA works by means of thermal destruction of venous tissues. Laser energy is delivered to the desired incompetent segment inside the vein through a bare laser fiber that has been passed through a sheath to the desired location.
When using laser light, heat is generated within the zone of optical penetration by direct absorption of laser energy. Absorption is the primary event that allows a laser or other light source to cause a potentially therapeutic (or damaging) effect on a tissue. Without absorption, there is no energy transfer to the tissue and the tissue is left unaffected by the light. Scattering of light occurs in all biological tissues: blood, vessel walls, and perivenous tissue.
The advantage of EVTA is that it is minimally invasive and can easily be performed under local tumescent anesthesia without need for spinal or general anesthesia and that the recurrence rate of the thermal techniques is lower than of surgery.
At the end of the surgical procedure, venous compression was applied for 24 h by irremovable compression bandage.
A clinical history is taken, and physical examination, including duplex ultrasound (US) imaging evaluation of the superficial venous system, is performed in the limbs of patients with varices suspected of arising from the GSV or the SSV. Patients with impalpable pedal pulses; cardiovascular disease; inability to ambulate; deep vein thrombosis; general poor health; and patients who are pregnant, nursing, or planning to become pregnant are usually not treated. Patients with extremely tortuous GSVs or SSVs that would not allow endovenous catheterization and passage of the laser fiber as identified on pretreatment venous duplex US mapping are excluded.