Why punchers are important
Perforating veins connect the deep veins with the saphenous veins and normally allow blood to pass in only one direction - inward. When their valves collapse, blood under high pressure is dumped out into the saphenous veins. It is the incompetent perforators that most often support trophic disorders and non-healing ulcers on the lower leg, and also cause relapse of varicose veins after previously performed operations. The perforator is found during duplex scanning and processed pointwise: a short light guide is inserted directly into it under ultrasound control. The procedure is quick and is often performed as an addition to the treatment of the main trunk.
How laser replaced surgery
Classic phlebectomy required incisions in the groin and lower leg, anesthesia and several days in the hospital, leaving scars. Endovasal laser coagulation has changed the approach: the vein is not removed, but is closed from the inside through one puncture with a needle.
The body gradually turns a closed vein into a thin connective tissue cord that dissolves. In this case, the blood flows through deep and healthy superficial veins - there are enough of them, since the varicose vein no longer fulfilled its function anyway.
Why does the price depend on the number of veins
The cost is determined by how many venous trunks are to be processed. This is not a marketing gradation, but a volume of work: each vein requires a separate puncture, a separate light guide along its entire length, a separate tumescent anesthesia along the trunk and a separate ultrasound control at each stage.
How many veins are affected is determined by duplex scanning before surgery - that is why it is mandatory and it is its result that determines the final cost.
Tumescent anesthesia
A large volume of highly diluted anesthetic is injected along the vein. It solves three problems at the same time: it relieves pain, compresses the vein around the light guide for better contact, and creates a protective “water cushion” that protects surrounding tissues and nerves from thermal effects. General anesthesia is not required.
What happens after
The patient goes home after 1–2 hours and walks independently. In the first days, there may be a pulling sensation along the treated vein and slight bruising - this is a normal reaction. They return to office work the next day, and to sports after 3–4 weeks.