Laser

The word is derived from the first letters of the phrase “light amplification by stimulated emission of radiation”. The name “laser” thus describes a relatively complicated procedure in physics and is used for the device with which the beams are produced as well as for its physical effect.

Laser beams are electromagnetic waves that hit human tissues as strongly bundled beams. Depending on the duration and intensity of the exposure, the thermal effects range from slight warmth to carbonisation of the tissue.

Lasers have a wide range of uses today, but must always be used properly. For example, shining a laser pointer into someone’s eyes may damage their eyesight.

Lasers are basically medical devices and not medicinal products (medicines).

Besides surgical methods, radiofrequency ablation therapy, and foam sclerotherapy, laser therapy has proved useful in the treatment of trunk varicose veins. It is also referred to as endoluminal or endovenous laser therapy (EVLT). Treatment usually costs in the region of 1500 EUR.

A special catheter is first inserted into the diseased vein under ultrasound guidance and the laser fibre is then pushed through the catheter. A laser beam is emitted through the fibre and the vein closed step by step by gently and continuously pulling back the fibre. The diseased vein is in effect burnt. The area treated has to be kept cool because of the heat generated during the procedure. Burns, scabbing, and scars may occur if the area is not adequately cooled or the laser system is not adjusted correctly.
Laser therapy can be performed as an outpatient (ambulatory) procedure and does not need a general anaesthesia. Instead, tumescent anaesthesia (a special form of local anaesthesia) is used. Tumescent anaesthesia builds a fluid firewall around the veins that prevents heat from being transmitted to the surrounding tissues and causing damage to nerves and vessels.

It is more difficult to push the catheter through tortuous snake-like varicose veins, as found in side branch veins, without perforating the vein. Other methods are usually to be preferred in such cases.

Small lasers may sometimes be used to treat spider veins in the legs. It is not, however, the method of choice and is very painful. Sclerotherapy is the method of choice for spider veins.