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Endoluminale Lasertherapie bei Varikosis

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Lasertherapie der Haut

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Zusammenfassung

Die endovenöse Laserablation (EVLA) wurde als Alternative zum chirurgischen Eingriff an der Vena saphena magna und der Vena saphena parva entwickelt, um die Krankheitshäufigkeit zu reduzieren und die Abheilungszeit zu verkürzen. Die EVLA kann in einem Eingriffsraum stationärer Einrichtungen erfolgen. Das Wirkprinzip der EVLA basiert auf der thermischen Zerstörung des Venengewebes. Dafür können verschiedene Wellenlängen eingesetzt werden: 810, 940, 980, 1.064, 1.320, 1.470 und 1.500 nm. Die durch den Laserstrahl erzeugte Hitze nimmt mit der Gewebetiefe ab, da Absorption und Streuung den Strahl abschwächen. Es ist wichtig, die Gefäßwand zu erhitzen, nicht das Blut. Bevor mit der EVLA begonnen werden kann, muss das Blut aus dem Venenlumen entfernt werden. Dies geschieht durch Hochlagerung des Beins (Trendelenburg-Lagerung), manuelle Kompression und subkutane Infiltration mit einer Tumeszenzlösung in die Venenumgebung. Die geeignete lineare endovenöse Energiedichte (LEED) muss im Verhältnis zum Durchmesser des zu behandelnden Segments stehen. Venen, deren Durchmesser mehr als 9–12 mm betragen, sind schwer zu behandeln, selbst bei höheren Energiedichten. Die Nebenwirkungen sind bei diesem Verfahren im Allgemeinen energieabhängig. Bei einer LEED von mehr als 100 J/cm2 kommt es oft zu Hautverbrennungen und tastbaren Verhärtungen.

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Author information

Author notes

  1. Serge Mordon Prof. Dr.

    Present address: INSERM U 703, Université Nord de France Lille University Hospital, CHRU Lille, Lille, Frankreich

  2. Marc Vuylsteke Dr.

    Present address: Department of Vascular Surgery, Sint-Andriesziekenhuis, Tielt, Belgien

Authors and Affiliations

    Authors
    1. Serge Mordon Prof. Dr.
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    2. Marc Vuylsteke Dr.
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    Correspondence to Serge Mordon Prof. Dr. .

    Editor information

    Editors and Affiliations

    1. Laserklinik Karlsruhe, Karlsruhe, Deutschland

      Christian Raulin

    2. Klinikum Darmstadt, Darmstadt, Deutschland

      Syrus Karsai

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    Mordon, S., Vuylsteke, M. (2013). Endoluminale Lasertherapie bei Varikosis. In: Raulin, C., Karsai, S. (eds) Lasertherapie der Haut. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-29910-0_16

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    • DOI: https://doi.org/10.1007/978-3-642-29910-0_16

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