Modern concepts on the mechanisms of endovasal laser coagulation in varicose vein disease

Mechanisms of endovasal laser coagulation (EVLC) applied in varicose vein disease are not fully understood.Purpose. To analyze currently applied EVLC mechanisms so as to prevent hemorrhagic complications and paresthesia caused by these mechanisms.Methods. This review analyses modern theories on EVLC mechanisms when applied in varicose vein disease in the lower extremities.Results. Published experimental and clinical trials, including histological ones, have shown that the degree of vein damage during EVLC session depends on many factors, such as wavelength, intensity, and optical fiber speed. Damage to veins during EVLC procedure depends on various factors, such as direct contact of the vein wall with an optical fiber tip, carbonization of blood elements leading to the increased intravenous blood temperature and to the formation of gas bubbles as well as heat convection on the vein wall through the blood.Conclusion. Destruction of the vein wall during EVLC procedure is the result of a synergistic effect of various damaging factors. Currently, 2-μm laser irradiation is being implemented into clinical practice. This technique provides better vein coagulation under less power values which promotes less postoperative complications.