Endovenous Laser Ablation-Phlebectomy-Sclerotherapy Hybrid Treatment for Venous Insufficiency: A Case Report

A hybrid treatment approach was used to successfully manage bilateral varicose veins in a 50-year-old female patient. The patient had venous insufficiency and presented with pain, swelling, and discoloration in her legs. The treatment plan consisted of two sessions of endovenous laser ablation (EVLA) to treat venous reflux, followed by two phlebectomies for residual bulging varicose veins. After a three-month follow-up, an ultrasound evaluation showed no venous reflux, indicating successful treatment. However, small reticular and spider veins remained, so the patient underwent four sessions of foam sclerotherapy using polidocanol as the sclerosant. On her three-month follow-up post-sclerotherapy, the patient reported significant improvement in symptoms, and ultrasound evaluation showed no venous reflux in major veins. The hybrid approach combining EVLA, sclerotherapy, and phlebectomy provided effective treatment for the patient, resulting in symptom improvement and positive cosmetic outcomes.