Which is a better option for vein removal (vein stripping or laser treatment/ELA) in the presences of a varicose ulcer around the size about 5cm? The patient is known to have hypertension which is under control.
Anything minimally invasive and not requiring hospital/surgery centers with either general anesthetic or conscious sedation is better. Endovenous laser ablation is an office based treatment under local anesthetic which will seal the underlying saphenous vein which is "faulty" / refluxing. In an experienced surgeons hands, the varicose veins can be removed through tiny punctures which do not require stitches, microphlebectomy. Walk in, walk out. Minimal downtime (a day or so). Stripping can takes weeks for recovery and is more painful. Controlled hypertension will not be an issue.
Published on Jul 11, 2012
The best treatment is endovenous laser ablation. It is the safest and most effective modality.
Vein stripping is an outdated procedure.
Published on Jul 11, 2012
Laser treatment is currently the gold standard for the treatment of venous reflux leading to either varicose veins or chronic venous insufficiency and venous ulcerations.
Published on Jul 11, 2012
Depends on patient but in general ablation is doable for almost all patients with good results even with large veins.
Michael D. Ingegno MD
Published on Jul 11, 2012
Endovenous thermal ablation is preferred over vein stripping in the vast majority of cases. In the presence of a stasis ulcer, it is common for incompetent varicose veins or perforating veins to be present which often are treated with foam sclerotherapy. This can be a complex issue and consultation with an experienced phlebologist is important.
Stephen F. Daugherty, MD, FACS, RVT, RPhS
Published on Jul 11, 2012
We perform laser ablation (usually with additional sclerotherapy to adjacent varicosities) and have a great deal of success with healing ulcerations. Most recent studies demonstrate that laser ablation offers better long term success with less initial downtime and pain. The most important issue for the patient is to have an ultrasound performed by an experienced clinic so that all the abnormal sources of reflux can be identified prior to any procedure being performed. Hypertension will not be a problem with laser ablation; I cannot speak for hypertension in the setting of vein stripping as I do not perform stripping.
Published on Jul 11, 2012