1st order
- Varicose sclerotherapy (also called sclerotherapy) – sclerotherapy of varicose veins by injecting a substance that causes sclerosis due to an inflammatory stimulus; preferred for spider vein varicose veins and reticular varicose veins
- Thermal ablation by means of laser therapy, e.g. as endoluminal laser therapy (ELT) or endovenous laser ablation (EVLA) – a radial laser can emit the laser energy in a ring around the catheter tip directly into the vein wall and thus obliterate it; indication: insufficient truncal veins
- Vein stripping – this method refers to the removal of the superficial veins down to the lowest insufficient vein; performed in cases of truncal varicosis and simultaneous perforating varicosis
- Subfascial ligation – refers to the severing of the connecting veins between the deep and superficial venous systems; is performed in cases of perforator varicosities
- Extraluminal valvuloplasty; in this procedure, plastic skin is placed tightly around the vein at critical points, thereby constricting it (“internal support stocking”); venous valves can thus close again and blood no longer flows downward, allowing the vein to recover. However, the long-term efficacy of extraluminal valvuloplasty has yet to be demonstrated.
Note on therapeutic success
- According to one study, the success rate after sclerotherapy is the lowest:
- When comparing the procedures endovenous laser ablation (EVLA; see above), sclerotherapy and surgery, after 5 years the disease-related quality of life was assessed better after surgery and EVLA than after sclerotherapy (here: foam sclerotherapy).
