[Laser surgery on varicose veins].

INTRODUCTION: With the development of medicine, technical inventions have been intoduced into the therapy of varicose veins, such as ultrasound examination and laser treatment.

PATIENTS AND METHODS: Over 11 years 1729 laser surgery were performed on varicose veins. Junctions of saphenous veins, saphenous stems and perforator veins were treated with lasers, but reticular and spider veins were treated with other methods. The most important elements of laser surgery are the introduction of the laser fibre into the lumen of the vein and delivering the laser energy. All of this is performed without incisions under ultrasound guidance. Laser crossectomy is an innovation in our technique. This procedure is performed under a combination of local and intravenous anaesthesia.

RESULTS: After 1 year 58% of operated legs (998) were checked (mean 3.3 years) and recurrent varicosity was found in 114 legs (11.4%). Recurrences were found mainly in those cases which would have been excluded from other studies, but in everyday practice they occur in a high percentage, such as being overweight, after delivery and previously operated cases. In selected cases, the recurrence rate is only 6.0%. Complications after laser surgery are less frequent than following classic varicose vein surgery.

CONCLUSIONS: According to international guidelines and this study, endovascular interventions can be recommended instead of classic varicose vein surgery because they are less demanding, and cause fewer complications. Using laser crossectomy, the number of early recurrences decreases. All stem varicosities are suitable for laser surgery.