If the venous valves wilt, treatment for varicose veins can be dangerous. Inflammation, blood clotting (thrombosis) or ulcers are common problems. Meanwhile, there are a whole range of promising therapeutic concepts.

What type of treatment in each individual case the best is, depends on the nature and number of affected veins, “says the professor Curt Diehm, one of the most vascular specialists in Germany and chief physician of internal medicine at the Klinikum Karlsbad-Langensteinbach. The operation methods in detail:


This mini-intervention (sclerotherapy) is used mainly in spider veins and small, so-called side branch varicose veins. Here, a special fluid is injected directly into the varicose vein. It comes to an artificially induced inflammation, glued the vein is no longer supplied with blood and thus permanently sealed. Cost: 100 euros per session. Usually between two and five sessions are necessary. The costs are not covered by statutory health insurance.

The Stripping

This is the classic for the removal of varicose veins stronger. Every year, as around 300 000 people in Germany can sever a defective vein. With the help of a probe it is pulled through a small skin puncture (stripped). Advantage: Only the diseased portion of the varicose vein is removed, the remaining veins remain parts obtained (eg for a possible later required bypass surgery.). The costs are covered by health insurance.

The “CHIVA technique”

When CHIVA method, the diseased vein is not pulled out, but remains in the body. CHIVA is the abbreviation for the French “cure hémodynamique de l’insufficience veineuse en ambulatoire”. It describes the technique to bond the main varicose vein at the point where it empties into the diseased portion. This can no longer reverse the blood flow. If then reduces the venous pressure, the faulty vein to regenerate. Experts are still arguing if that works. Cost: 400-1500 Euros per leg. Many of CHIVA centers (see www.chiva-info.de) have already signed contracts with the cash.

The laser treatment

More and more often comes in the varicose vein treatment is a new and gentle laser generation for use. In the so-called “endoluminal laser therapy” the laser probe is inserted generally under local anesthesia through a tiny incision into the diseased vein. The energy of the laser light “welded” their inner walls and makes them shrink. The varicose vein must not be removed, because the body is breaking down the vein within a few months. Cost: 600-1500 Euros per leg.

The radio wave therapy

In each case at the lower end of the diseased vein segment (either at the knee or the lower leg) a tiny radio-frequency catheter is inserted through a small incision into the diseased vein. The heat energy shrinks the vein wall, the vein closes. The advantage over the laser treatment is in a considerably lower heat load on the fabric. In the normal radio wave therapy it is between 80 to 120 degrees Celsius, at between 700 and 900 degrees laser. The treatment can be performed on an outpatient basis under short general anesthesia or under local anesthesia. Cost: about 1200 to 1500 Euros per leg.

The foam sclerotherapy

The foam sclerotherapy, as the technical term, is a therapy that has revolutionized the treatment of varicose veins. Could be previously deserted just spider veins and varicose veins smallest (see sclerotherapy), even large veins may be treated with the foam sclerotherapy. The principle is simple: The sclerosing agent is not just pure injected into a vein, but foamed prior to injection with sterile air. The Schaumverdrängt the blood from the vein and bonded to the inner wall. The treatment can be performed on an outpatient basis. Even after one or two days, the patient is fit to resume work. Cost: per session about 100 euros. Usually between two and five sessions are necessary. In general: For varicose veins do not come back, the treated vessel specialist should have as much experience.