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Venous Procedures

Endovenous procedures are minimally invasive treatments that, in addition to an excellent safety profile, guarantee the highest effectiveness among all venous disease treatment methods currently available on the market.

INTRODUCTION

Modern phlebology offers a range of minimally invasive methods for treating venous diseases. Endovenous techniques provide a safe and effective alternative to traditional vein surgery. These procedures are performed under local anesthesia (typically tumescent anesthesia) without the need for extensive skin incisions. This results in minimal tissue trauma, faster recovery, and a superior cosmetic outcome.

In contrast to traditional vein stripping endovenous procedures are performed on an outpatient basis. Patients can leave the clinic on the same day and quickly return to their daily activities. Modern vein treatment techniques are characterized by high effectiveness and a significantly lower risk of complications.

PHLEBOLOGICAL INDICATIONS FOR ENDOVENOUS METHODS

Endovenous procedures are used to treat a wide spectrum of venous system disorders. The most common venous pathologies treated with these methods include:

  • venous insufficiency of the lower extremities (C2 – varicose veins);
  • complicated venous insufficiency of the lower extremities (C4–C6);
  • recurrent venous disease;
  • pelvic venous insufficiency (PVI);
  • venous compression syndromes and phenomena;
  • venous malformations;
  • venous thrombosis;
  • post-thrombotic syndrome (PTS).

THERMAL VERSUS NON-THERMAL METHODS

At the Phlebology Clinic, we utilize both non-thermal and thermal methods for the treatment of lower limb venous disease. The choice of a specific method or a combination of techniques (a hybrid approach) depends on the individual needs of the patient and the nature of the venous disorder.

Non-thermal methods

  • needle sclerotherapy and its variants (liquid,
    microfoam, and foam sclerotherapy);
  • simple catheter-directed sclerotherapy;
  • mechanochemical vein ablation (MOCA);
  • medical vein gluing (VenaSeal, VariClose
    VenaBlock, VeinOff).

The primary advantages of non-thermal methods are the elimination of tumescent anesthesia and the minimal risk of damage to surrounding tissues.

Thermal methods:

  • endovenous laser ablation (EVLA);
  • radiofrequency thermal ablation (RFA);
  • steam vein sclerosis (SVS).

Thermal ablation techniques utilize thermal energy to seal the insufficient venous segment. They are characterized by very high long-term effectiveness.

LOWER LIMB VARICOSE VEINS – TREATMENT METHODS

ENDOVENOUS LASER ABLATION (EVLA)

ENDOVENOUS LASER ABLATION (EVLA) represents the gold standard in minimally invasive treatment of venous insufficiency. Currently, the 1470 nm wavelength laser light is considered the most effective. It is exceptionally well absorbed by the water within the vein wall, leading to controlled thermal damage and permanent occlusion of the vessel lumen.

Laser ablation is performed under tumescent local anesthesia, guided by high-resolution ultrasound imaging. Modern laser systems equipped with 2-ring radial fibers ensure uniform energy distribution, minimizing the risk of vein wall perforation and thermal complications.

The effectiveness of EVLA reaches 95–98% in long-term follow-up, making it one of the most reliable methods for treating varicose veins. Clinical studies (including those conducted at the Phlebology Clinic) have demonstrated that the recanalization rate (reopening of the vein) for veins closed using EVLA is significantly lower than in cases of traditional surgery, medical glue, or sclerotherapy. Furthermore, should venous disease recur, the procedure can be safely repeated.

VENOUS EMBOLIZATION AND ITS ROLE IN CAUSAL TREATMENT

Venous Embolization is a breakthrough method in the treatment of pelvic venous insufficiency – the most common cause of lower limb venous insufficiency and the phenomenon responsible for pelvic congestion syndrome symptoms (PCS) as well as the development of vulvar and perineal varicose veins. Embolization procedures involve the controlled and precise closure of insufficient veins using specialized coils or sclerosing agents, which are introduced into the vessel lumen under radiological guidance. In the context of causal treatment, venous embolization plays a key role in the following clinical situations:

  • Venous compression syndromes – in combination with venous stenting or
    venous venoplasty, it enables comprehensive treatment of the underlying problem;
  • Pelvic venous insufficiency – by closing insufficient venous trunks
    it eliminates the source of reflux and congestive venous insufficiency in the lower limbs;
  • Recurrent venous disease – it allows for the elimination of abnormal venous connections
    descending from the pelvis (venous leaks), which are a primary cause of recurrence.

The main advantages of venous embolization are:

  • access to anatomically challenging areas of the venous system that are unreachable through traditional surgery;
  • high effectiveness in eliminating the root causes of venous reflux and pelvic congestion;
  • minimally invasive nature of the procedure, typically performed under conscious sedation rather than general anesthesia
  • fast recovery and a quick return to normal daily activities (usually within 5–10 days).

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Do you have questions? Aleksandra, a virtual Patient Coordinator, will assist you at any time of the day or night

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  • Wawelska Street Branch - 5 Wawelska Street
  • Puławska Street Branch - 17 Puławska Street

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