HOW IS PHOTODYNAMIC THERAPY OF VARICOSE VEINS APPLIED?
1.- A complete medical history should be taken.
2.- A colour Echo-Doppler is systematically done to assess the deep venous system, femoral or popliteal drainage of both saphenous veins and the competence of perforating veins.
3.- In isolates cases, a contrast phlebography might be indicated.
4.- Photographic study and venous mapping.
5.- Canalisation using butterfly catheters of the entry sites where the polydocanol foam will be injected along the varicosed segment.
6.- Injection of the polydocanol microfoam. This can be done through the catheters into large dilated vessels or by means of small 30 G needles in case of small telangiectasias, as shown in the illustration.
7.- Next, the Nd:YAG laser is triggered targeting the varicose veins that have been previously infiltrated with the polydocanol.
8.- In large varices, a new ultrasound is performed to check the efficacy of the treatment.
9.- Compression wrap for 1 to 2 weeks or compression legging depending on each case, for about one month.
10.- The patient is discharged and instructed to take anti-inflammatory agents and to apply creams to help the skin heal from possible haematomas or any other skin alteration.
11.- Seven to 12 days after the treatment, the patient comes for his or her follow up visit.
12.- Subsequent to this first visit, a 2-year follow up is performed until final discharge of the patient.
