Case of the Month

Title: Large varicose vein on the calf - vein therapy with an incredible immediate result

Patient: B.N. male, 30 yrs., symptoms: large varicose veins in the left calf area for several years, nocturnal calf cramps.

Preliminary examination at a university clinic's vein center; diagnosis: insufficiency of the left great saphenous vein. Recommendation: high ligation of the great saphenous vein with stage-appropriate stripping, followed by sclerotherapy of the superficial side branches. 6 weeks of compression stockings.

Our diagnostics: The great saphenous vein (inside of the upper and lower leg) is not the cause of the problem – it is completely healthy except for a small side branch - but rather the small saphenous vein (popliteal fossa to the lower calf area). Furthermore, the deep leg vein (popliteal vein) is insufficient. The visible varicose veins fill from the popliteal fossa.

Our treatment: Preparation with marking of the problem zone (A), endovenous laser of the small saphenous vein (this begins approximately at the level of the popliteal fossa, lies 1 cm under the skin and is invisible, although it is the cause of the varicose veins) under local anesthesia (B). In the same procedure, without further puncture, treatment of the visible varicose veins. (C) shows the lower leg at the end of the approximately 25-minute treatment. The Venartis film dressing (D) stabilizes the beautiful result and allows for sports and showering. Discharge symptom-free.

Comment: This case was selected to draw attention to the importance of the correct diagnosis. In this case, due to an error, there would have been 1.) an unnecessary operation, 2.) removal of the wrong (healthy) vein, 3.) an unnecessary second appointment (sclerotherapy), 4.) unnecessarily long compression treatment and 5.) unfortunately no treatment of the actual cause of the disease.

Conclusion: A therapy can never be better than the diagnosis. The images show how simple the correct solution is