Endovenous laser or radiofrequency treatment of varicose veins

Endovenous treatment is a modern alternative to stripping for varicose veins caused by a faulty saphenous vein. Instead of removing the vein, it is closed from the inside: it gradually turns into a fibrous cord that the body absorbs. Blood then flows through the healthy veins. The doctor punctures the vein under ultrasound guidance, usually at the knee or calf, and slides a laser fibre or radiofrequency catheter up to the top of the thigh. After injecting a numbing fluid around the vein (tumescent anaesthesia), the fibre is slowly withdrawn while heating the vein wall, which seals the vein. Visible varicose branches can be removed at the same time through small phlebectomies. This technique is suitable when the saphenous vein is fairly straight and of the right size, as shown by duplex ultrasound. It leaves few marks, causes less bruising than stripping and allows a quick return to normal activities. The choice between laser, radiofrequency and surgery is made with the surgeon according to the anatomy of the veins. At Clinique Pasteur Tunis, this treatment is carried out as day surgery, under ultrasound guidance, most often under local anaesthesia, with discharge home the same day.