Potential for laser coagulation in the treatment of varicose vein disease in adolescents

Introduction. In recent years, there has been a trend toward younger patients with chronic venous disease (CVD). Only a few publications on this topic exist in the domestic and internationalliterature, which do not provide clarity on patient management strategies.

Aim. To evaluate the feasibility of using modern minimally invasive techniques in the treatment of pediatric patients with varicose veins.

Materials and methods. The study included 30 adolescents with clinical class C2 varicose veins; aged up to 18 years. The mean age was 15.9 ± 1.5 (12–17) years. The mean patient height was 175.9 ± 10.0 cm, body mass index was 21.5 ± 2.7 kg/m2. Venospecific symptomss were noted in 23 patients (76.7%): pain (n = 23), swelling (feeling of swelling, n = 8), excessive fatigue (n = 6). A total of 34 surgical interventions were performed: endovenous laser obliteration of the great saphenous vein (GSV) – 26 (76.5%), the small saphenous vein – 8 (23.5%), and the anterior accessory saphenous vein – 2 (5.9%). In 29 cases (85.3%),laser obliteration was supplemented by microphlebectomy of the tributaries.

Results. These duplex scanning data were evaluated over a 12-month period in 28 (86.7%) patients. Target vein occlusion persisted in 96.9%. In one case, partial recanalization of the GSVlumen was observed without recurrence of clinical symptoms. Positive dynamics in subjective complaints were noted: a decrease in pain severity from 2.5 ± 0.5 to 1.2 ± 0.3 (p < 0.05), and swelling from 2.4 ± 0.5 to 0.4 ± 0.2 points (p < 0.05) on the visual analog scale.

Conclusions. The obtained data allow us to consider EVLT with a wavelength of 1940 nm as the method of choice for the treatment of varicose veins in children and adolescents. There is a need for continued research in this area to more clearly substantiate the tactics of active surgical treatment for patients in this age group.

1. Weindorf N, Schultz-Ehrenburg U. The development of varicose veins in children and adolescents. Phlebologie. 1990;43(4):573–577. Available at: https://pubmed.ncbi.nlm.nih.gov/2093907.

2. Lee AJ, Robertson LA, Boghossian SM, Allan PL, Ruckley CV, Fowkes FG et al Progression of varicose veins and chronic venous insufficiency in the general population in the Edinburgh Vein Study. J Vasc Surg Venous Lymphat Disord. 2015;3(1):18–26. https://doi.org/10.1016/j.jvsv.2014.09.008.

3. Studennikova VV, Severgina LO, Dzyundzya AN, Korovin IA. Lower extremity varicose veins in children and young adults: mechanism of development and specific features. Arkhiv Patologii. 2027;(4):56–60. (In Russ.) https://doi.org/10.17116/patol201779456-60.

4. Terlecki P, Przywara S, Iłżecki M, Terlecki K, Kawecki P, Zubilewicz T. Endovenous laser ablation is an effective treatment for great saphenous vein incompetence in teenagers. Phlebology. 2016;31(3):198–202. https://doi.org/10.1177/0268355515585436.

5. Minaev VP, Bogachev VYu, Kaperiz KA. Endovenous laser coagulation of varicose veins: evolution continues. Ambulatornaya Khirurgiya. 2023;20(1):174–184. (In Russ.) https://doi.org/10.21518/akh2023-002.

6. Perrin M, Eklöf B, Van Rij A, Labropoulos N, Vasquez M, Nicolaides A et al. Venous symptoms: the SYM Vein Consensus statement developed under the auspices of the European Venous Forum. Int Angiol. 2026;35(4):374–398. Available at: https://pubmed.ncbi.nlm.nih.gov/27081866.

7. Nurmeev IN, Mirolyubov LM, Mirolyubov AL, Nurmeev NN, Osipov AYu, Nurmeeva AR, Rashitov LF. Treatment of chronic venous diseases in children and adolescents. Angiology and Vascular Surgery. 2016;22(1):105–108. (In Russ.) Available at: https://angiolsurgery.org/magazine/2016/1/13.htm.

8. Andraska EA, Horne DC, Campbell DN, Eliason JL, Wakefield TW, Coleman DM. Patterns of pediatric venous disease. J Vasc Surg Venous Lymphat Disord. 2016;4(4):422–425. https://doi.org/10.1016/j.jvsv.2016.06.004.18.

9. Patel PA, Barnacle AM, Stuart S, Amaral JG, John PR. Endovenous laser ablation therapy in children: applications and outcomes. Pediatr Radiol. 2017;47(10):1353–1363. https://doi.org/10.1007/s00247-017-3863-4.

10. Zolotukhin IA, Seliverstov EI, Shevtsov YN, Avakiants IP, Nikishkov AS, Tatarintsev AM, Kirienko AI. Prevalence and risk factors for chronic venous disease in the general Russian population. Eur J Vasc Endovasc Surg. 2017;54(6):752–758. https://doi.org/10.1016/j.ejvs.2017.08.033.

11. Doronin IV, Minaev SV. Diagnostics and treatment of chronic venous diseases in children and teenagers. Flebologiya. 2011;5(1):53–55. (In Russ.) Available at: https://www.mediasphera.ru/issues/flebologiya/2011/1/031997-69762011110.

12. Mahmoud M, Nasser MM, Ghoneim B, Daly WE, Mahdy HE. Comparative study between endovenous laser ablation (EVLA) with 1940 nm versus EVLA with 1470 nm for treatment of incompetent great saphenous vein and short saphenous vein: A randomized controlled trial. J Vasc Surg Venous Lymphat Disord. 2025;13(1):101960. https://doi.org/10.1016/j.jvsv.2024.101960.