Endovenous laser ablation in chronic venous insufficiency of the lower extremity: a minor horizon on its effectiveness, safety, and application

Chronic venous insufficiency (CVI) remains as a significant public health problem. While open surgery was the gold standard until the 1990s, minimally invasive endovenous thermal ablation (EVTA) techniques have become the first-line treatment option for its treatment in recent years. It is considered that the partial reduction in morbidity, the increased safety and effectiveness of EVTA, and the possibility of performing these procedures in an outpatient setting play a significant role in the strategy of transition from surgery to EVTA. The most commonly used EVTA techniques are radiofrequency ablation (RFA) and endovenous laser therapy (EVLA). Both use a heat-producing mechanism to seal the vein, without general anesthesia. They are performed by administering tumescent anesthesia along the length of the vein under ultrasound guidance to protect the perivenous tissue from thermal injury. In EVLA, different types of laser fibers, wavelengths and radial tips are used. Laser diodes convert electricity into photons, or light, and the photons are then pumped into the fiber optic cable to generate heat. Heat damages the vein, causing it to become blocked and over time to be eliminated by the body’s natural mechanisms. It is comparable to other endovenous methods in terms of technical success, improving the patient’s quality of life and side effects at an acceptable level. In conclusion, endovenous laser ablation is an effective, minimally invasive, feasible and mostly safe treatment method for great saphenous vein insufficiency.