Endovenous Laser Treatment of Varicose Veins: Practical Technique
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Varicose veins are a global health problem that has a socio-economic impact. Developed countries have a huge expenditure for annual as well long term care of this condition. This abnormal leg condition has various types of presentation, sometimes-vague symptomatology. Identifying these symptoms and arriving at confirmed diagnosis is the first step to relieve this worldwide disease. Traditionally, management of varicose veins has been surgical, which at best provides temporary relief, sometimes-residual disease, and often recurs. However, with the introduction of newer interventional techniques, scenario of varicose veins management has entirely changed in past few years. The endovenous procedures, as they are commonly labeled, have not only improved the morbidity related to this disease, but also achieved higher technical success rate. Widely prevalent amongst such techniques has been the Endovenous Laser treatment. This procedure is performed all across the globe in a variety of fashion, which basically comes down to same underlying mechanism of action. In proper skilled hands though, the results may vary. However, anyone intending to perform this procedure may initially have innumerable questions pertaining to this disease and treatment techniques, some of which could be trivial and others critical. With the aim that the beginners, health care practitioners, physicians, referring consultants, undergraduate and postgraduate medical students of various specialties and subspecialties understand this procedure easily and hopefully thoroughly, we have taken this step to write our experience. One critical component of this as well as other endovenous procedures though is ultrasound guidance, and hence knowledge of vascular ultrasound, particularly venous exam is a kind of unspoken requirement. We have tried to include the relevant information that one may find useful during the learning curve phase of the procedure, and also serve as a valuable tool to refer to, anytime later during the practice. The book includes lower limb venous anatomy, pathophysiology of chronic venous insufficiency, clinical presentation and diagnoses of varicose veins. The detailed step in management of this condition by endovenous laser and sclerotherapy has then been explained, which includes the post procedure expectations.
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