Iatrogenic Complications Following Laser Ablation of Varicose Veins

During the past decade, Endovenous Laser Ablation (EVLA) has been introduced as a minimally invasive alternative to high ligation and open surgical stripping of the incompetent Great Saphenous Vein (GSV) or Short Saphenous Vein (SSV). There is great variability in EVLA protocols and at the present time there is data from more than 60 publications with more than 15000 EVLA treatments reporting good clinical results but also undesired side effects. Post-operative pain in the operated area is rated from slight to moderate by most patients (81, 5%),post-operative induration of the truncal vein can be expected in 78, 1% of patients and perivenous ecchymosis and hematoma are observed in an average of 52% of patients. Further complications such as persistent dysesthesia after nerve lesions (0, 8%) and burns on the skin (0, 2%) are reported in a minority of cases. Great care must be taken to ensure adequate tumescent anesthesia and light dosimetry in order to avoid post-operative paresthesia.