Minimally invasive, endovenous laser treatment of varicose veins in patients with von Willebrand disease.

The presented report presents a minimally invasive approach for the treatment of varicose veins in patients with chronic venous disease and coexisting von Willebrand disease, the most common inherited bleeding disorder. Conventional stripping of an insufficient great saphenous vein and varicose vein surgery, carries a potential risk of serious bleeding complications in this specific group of patients. It is related to the extent of open surgery, significant tissue trauma, and possible post-operative bleeding of wounds. Less aggressive techniques, such as endovenous laser treatment or radiofrequency ablation, gain increasing popularity as a valuable and equally efficient alternative to conventional surgery in patients with varicose veins. Both of these endovenous techniques seem to have special indications in patients with bleeding disorders. Shortening of hospitalization, quick recovery time and return to normal daily activities, optimal cosmetic effect of the procedure, are also advantageous. The paper presents the technique and results of endovenous laser treatment of great saphenous vein insufficiency and varicose veins in a patient with type I von Willebrand disease. Available data on peri-operative care standards, optimization of the safety of procedures, and prevention of bleeding complications in surgical patients with von Willebrand disease, specifically undergoing varicose veins surgery are analysed.