A new innovative method for treating venous disorders is now being used at GENESIS. Minimally invasive, safe, ideal for treating venous disorders often caused by pregnancy. The specialist vascular surgeons Dimitris Papadimitriou and Dimitris Mavros, who are in charge of the Venous Disease Clinic, use the most modern method for treating varicose veins and other conditions.
– Is it true that varicose veins and venous insufficiency can now be treated in such a simple and painless way as with laser therapy?
The treatment is painless, bloodless, and has a success rate of nearly 100%. It is a revolutionary micro-procedure that offers the highest precision in the control and treatment of all subcutaneous incompetent veins. The treatment of varicose veins is performed endoscopically and is now a routine procedure, offering spectacular results compared to open surgery.
– Are varicose veins and venous insufficiency a common disease among Greeks, and what should we watch out for before reaching a point where intervention is necessary?
According to statistics from the Hellenic Society of Angiology, more than 1,000,000 Greeks have a serious varicose vein problem that requires immediate treatment. Venous insufficiency is one of the most common conditions among women, affecting 40–45% of them, and among men, affecting 20–25% of them. This means that in our country, approximately 2,200,000 women suffer from mild (stage 1) to severe (stage 5) venous insufficiency, without all of them being aware of it. In addition, approximately 900,000 men suffer from the disease, which is often diagnosed for the first time in the army during military service. The preventive measures recommended by doctors are mainly walking, exercise, wearing elastic stockings, and avoiding the use of tight corsets.
– What ultimately causes someone to end up at the vascular surgeon with varicose veins and venous insufficiency and seek treatment?
The main causes, apart from those present at birth – defective veins or fewer valves – that contribute to venous insufficiency are: Heredity, prolonged standing due to occupation (surgeons, waiters, hairdressers, etc.), obesity, chronic constipation, chronic weight lifting (in various occupations), age (the frequency of varicose veins in people under 50 is 31%, while it exceeds 70% after the age of 50), pregnancy (due to pressure on the veins in the abdomen), taking hormones and contraceptives, sedentary work and lifestyle. The main symptoms experienced by those with varicose veins are: swelling, edema, pain, heavy limbs, burning sensations, tightness, itching, night cramps, numbness, bleeding, dermatitis ulceration around the ankle (venous ulcer, malignant degeneration). A common symptom of varicose veins is thrombophlebitis, in which the vein wall becomes inflamed, causing pain, and the skin becomes hard, hot, red, and swollen. Thrombophlebitis is 20 times more common in people with varicose veins. Of these, 8-40% affect the deep veins (thrombosis), resulting in 10% developing pulmonary embolism and sometimes death. Triplex venography (color ultrasound) is the test of choice for the diagnosis and treatment of venous diseases of the legs.
– What is laser treatment for varicose veins and venous insufficiency, how is it performed, and what are its advantages for the patient?
Endovenous laser treatment of varicose veins is a minimally invasive alternative to “classic” saphenectomy and is currently the most modern method for treating varicose veins. With this technique, the major or minor saphenous vein, i.e. the main vein that has valve insufficiency and has led to the appearance of varicose veins on the skin, is replaced by vaporizing the vein through the application of laser energy directly into the lumen of the vein.
The method is performed under ultrasound guidance at all stages, which are briefly as follows:
- Διαδερμική παρακέντηση με βελόνα της φλέβας υπό υπερηχογραφική καθοδήγηση και εισαγωγή του θηκαριού
- Εισαγωγή της ίνας Laser και προώθησή της μέχρι την συμβολή της σαφηνούς με την μηριαία φλέβα
- Έκχυση ειδικού αναισθητικού διαλύματος σε όλο το μήκος της φλέβας υπό υπερηχογραφική καθοδήγηση TUMESCENCE
- Activation of the laser and withdrawal of the fiber at a specific speed, destroying the vein. Continuous intraoperative ultrasound guidance, provided it is of good quality, ensures high accuracy and safety at all stages of the procedure. The procedure is completed with micro-phlebectomy of the varicose veins: a special anesthetic solution is injected into the varicose vein area and then the varicose veins are removed using a micro-technique through tiny holes, one millimeter in diameter. The laser technology used during the procedure is state-of-the-art. The laser beam emitted has a wavelength of 1470 nm, targeting water rather than blood, which ensures the success of the procedure and a painless postoperative period. The innovative Never Touch Direct Fiber has special mirrors at its tip that diffuse the laser beam at 360 degrees, acting evenly across the entire perimeter of the vein wall (Vena Cure EVLT, Angiodynamics).
The advantages of intraluminal laser treatment compared to “old school” sclerotherapy are particularly significant:
- The procedure is painless and is performed under local anesthesia. The team’s anesthesiologist usually administers a light sedative. General or regional (spinal or epidural) anesthesia is no longer necessary.
- The procedure is extremely safe and has minimal or no complications.
- The patient’s mobilization is immediate—the patient can walk immediately after the end of the operation.
- The immediate postoperative period is painless. It is characteristic that the vast majority of patients do not take any painkillers the day after the operation.
- The patient usually leaves the hospital within one to two hours after the procedure.
- The return to daily activities is immediate, while the return to work can take place in one to two days. The only requirement for the patient is to avoid lifting weights over 5 kg and to wear elastic stockings for two weeks.
- Since no surgical incisions or stitches are required, the aesthetic result is excellent, as the scars are almost invisible a few months after the procedure.
- The probability of recurrence after endovenous laser treatment of varicose veins is lower than with conventional phlebectomy. It should be noted that endovenous laser treatment of varicose veins is a method that requires high-tech material and technical infrastructure as well as high technical training -specialization of the vascular surgeon, who should be the only specialist physician to perform such detailed interventions. It should be emphasized that, according to the official guidelines of the Vascular Surgery Community of the United States and the American Venous Forum, endovascular treatment of venous insufficiency is recommended over surgical treatment (guideline 11.2 – Gloviczki et al, Journal of Vascular Surgery, May 2011).
This treatment is now available at the GENESIS Clinic!
Vascular surgeon Dimitris Papadimitriou is one of four vascular surgeons in Northern Greece selected by CANA Pharmaceuticals to be trained in the latest generation of Angiodynamics’ endovascular laser (Vena Cure EVLT, Angiodynamics) and the first to use it in a case in Northern Greece in September 2015. Since then, he has performed 40 procedures with this laser device, with complete success and only a few hours’ stay in the clinic. Patients not only returned home and resumed their normal activities on the same day, but also returned to work within three days, pain-free and without the problems associated with the open method.
The Vein Disease Clinic that we inaugurated at the Clinic and will be operating from June 2016 is the first step towards making the GENESIS Clinic a model center for the application of this method in Thessaloniki, combining innovation with the excellent technical infrastructure already known to the public in our city.
The cost of laser treatment?
The cost is slightly higher than that of open restoration due to the more expensive laser materials, but it is certainly not prohibitive. However, the advantages of the method and the absence of hospitalization in a clinic offset this small financial burden.
VEIN DISEASE CLINIC – GENESIS CLINIC
Contact numbers: 2310-984010, 6944-605353