Almost all varicose veins are accessible by EVLT: the great saphenous vein (internal saphenous vein), the small saphenous vein (external saphenous vein), the anterior and posterior saphenous veins and the perforating vein.
The technique has no limitations related to either the age of the patient, or the seriousness of the disease (
The technique has no limitations related to either the age of the patient, or the seriousness of the disease (
varicose ulcers
can benefit from this technique). Being overweight is not a contraindication either.Anatomic contraindications to EVLT are extremely rare in a first-line treatment, that is to say for a patient who has not been treated yet. They may include veins damaged by phlebitis (causing
intraluminal
obstacles), veins that are too tortuous (extremely rare), or with a diameter less than 2.5 mm or more than 45mm.In a second-line treatment, that is to say in the case of patients who have already had an operation without the appropriate
phlebologic
follow-up, recurrences are often more accessible by endovenous laser than by surgery (especially thigh perforating veins, on which second-line surgery gives mediocre results).
A Duplex scan is indispensable in order to make a proper diagnosis and to determine the appropriate therapeutic indication.
An annual Duplex scan and clinical examination is essential whatever the initial technique chosen.
Proper treatment and follow-up of varicose veins may prevent many complications, which may be irreversible.