Surgical treatment of varicose veins and endovenous therapy

The optimum treatment of varicose veins requires a precise identification of the source of venous reflux. Treatment should lead to the

obliteration of venous reflux, reduction of symptoms, improvement of aesthetics and prevention of complications – all this should go

hand in hand with low morbidity, low recurrence of the illness and also short-term convalescence. One of the greatest problems connected

with varicose veins of the lower limbs is their recurrence. At the moment 25 % of operations are carried out due to the recurrence of

the illness. Lowering the incidence of recurrence is a challenge for medical professionals. The best way of ensuring success is removing

the source of reflux immediately at the first operation.

A duplex scan of the whole lower limb is a much more precise examination method than other methods of examining the venous system

(clinical findings, examination with hand held Doppler and Duplex techniques) although it is not generally accepted as it is a time

consuming and expensive examination.

Minimal invasive alternatives in the treatment of varicose veins with saphenous-femoral junction (SFJ) and great saphenous vein (GSV)

incompetence have been tried over the years to increase patients’ comfort, reduce cost and risk. Radiofrequency ablation and endovascular

laser are new methods which replace traditional GSV stripping. These methods are less harmful for the surrounding tissues and

thus enable patients to return to their usual activities significantly quicker.

We should always remember that no method is perfect, it will never cure all the patients and it is necessary to select such a method that

will be effective enough and as little invasive as possible.

Keywords: saphenous-femoral junction (SFJ), great saphenous vein (GSV), laser RFA Closure®