# Interventional varicose vein therapy using endoluminal laser ablation (1940 nm) in patients with Ehlers‐Danlos syndromes: two case reports

## TL;DR

A new laser therapy successfully treated varicose veins in two Ehlers-Danlos syndrome patients without complications.

## Contribution

Endoluminal laser ablation at 1940 nm is introduced as a novel treatment for varicose veins in Ehlers-Danlos syndrome patients.

## Key findings

- Endoluminal laser ablation achieved adequate vessel closure in two Ehlers-Danlos syndrome patients.
- The procedure avoided intra- or postoperative complications despite vascular fragility.
- This approach offers a middle ground between conservative and open surgical treatments for these patients.

## Abstract

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.