Interventional varicose vein therapy using endoluminal laser ablation (1940 nm) in patients with Ehlers-Danlos...

In patients with Ehlers-Danlos syndrome, the presence of chronic venous insufficiency poses a particular challenge for physicians when determining the indication for surgical treatment. Due to vascular fragility, complications such as vascular tears or ruptures with difficult hemostasis and potentially life-threatening consequences occur particularly during open surgical procedures. The degree of vascular vulnerability varies among the different subtypes of Ehlers-Danlos syndrome but can be observed across all subtypes. We performed endoluminal laser ablation close to the saphenofemoral junction of insufficient truncal veins in two patients with Ehlers-Danlos syndrome using a 1940-nm radial fiber and achieved adequate vessel closure without intra- or postoperative complications. This procedure, described here for the first time, represents an approach between conservative varicose vein therapy and open surgical treatment and may be considered in patients with Ehlers-Danlos syndrome, particularly in cases of insufficient symptom control or a complicated disease course.