Varicose veins: Diagnosis and treatment

Today an early therapy of varicosis is recommended before health problems arise. In order to recognize and judge reflux and undiscovered obstacles in the veins nowadays in most cases Doppler techniques are used. Phlebography, an X-ray examination with contrast material, has largely been replaced by colour-coded duplex sonography, an ultrasound scan. With the help of this method thromboses or disorders of the venous valves can be precisely located. Veins can be treated in different ways: removal (by classical crossectomy and stripping), occlusion (with the help of endoluminal processes such as Venefit for example) or adhesion (sclerotization).

Vein Stripping

The open crossectomy has been the gold standard for more than 100 years and is paid by all health insurances. According to the position of the vein in question a cut is made in the groin or knee bend. The aim is to find the so-called cross, the intersection between superficial and deep veins. The superficial vein is closed, cut off and removed shortly before it reaches the deep veins. As the legs must be bandaged for several weeks it is advisable to perform the treatment only in the winter months. Bruising, infections, damage of sensitive nerves or thromboses may occur.

Endoluminal methods

When using endoluminal methods the vein is damaged from inside by release of energy. The varicose vein closes. The aim is that the body destroys the vein in question. The energy can be produced by means of radiofrequency (radiofrequency ablation RFA like e.g. Venefit®, laser (endovenous laser ablation ELVT) or vapour (endovenous vapour ablation EVSA).

The Venefit® (VNUS ClosureFast) RFA method is a minimally invasive therapy for varicose veins. You receive outpatient treatment under local anaesthetic; the risk of an infection is low. The damaged stem vein is treated with the help of a high-precision radiofrequency catheter. Only a small cut is necessary. Under ultrasound guidance the vein is heated up to about 120 degrees by high-frequency electric current radiofrequency and closed. After that it completely dissolves. Immediately after the operation sport is possible without any problems.

The endovenous laser ablation ELVT can be compared to radiofrequency therapy as far as the procedure is concerned. For the ELVT different lasers with wavelengths from 810 to 1470 nm are used. Average temperatures up to 700 degrees (Celsius) develop. Endonevous vapour ablation EVSA serves to close veins with the help of vapour. A catheter gives off hot vapour in two directions, the temperature of which may reach 120 degrees.


Like the treatment of spider veins Aethoxysklerol is injected into the varicose veins that need to be treated. But the veins are bigger so that a higher concentration is needed. Sclerotherapy only requires outpatient treatment and does not need any anaesthetization at all. As the success rate is rather low this method is only applied if none of the treatments described above is possible.

Learn more:
Venefit®: The most modern treatment


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