Treatment options / Therapy

Nowadays, there are different treatment methods available for varicose veins. Relying on our experience, we are convinced that the best results can only be achieved when the methods are combined. The currently accepted treatment options should not compete with each other, but complement each other.

Non-operative procedures:

- Sclerotherapy / obliteration of side branches and spider veins

Verödung von Besenreiser Phlebologie Krampfadern in 80331 München am Dom

The injection of a sclerosing agent leads to the closing of the vein, over time it will be resorbed by the body. The treatment takes only a few minutes, however, wearing a compression bandage or stocking is necessary for a few days. The method is intended for small and very small varicose veins but also for so-called spider veins i.e. Microsclerotherapy.

- Foam sclerotherapy

Schaumverödung von Besenreiser Phlebologie Krampfadern in 80331 München am Dom

This is a variation of sclerotherapy treatment. For this, the sclerosing agent is foamed before injection into the varicose vein. Thus, it has a stronger effect on the diseased veins. The same technique can be used to eliminate larger varicose veins.

More informationen about spider veins look at:

look at this video: "Varicose veins off"

Info at video: "veins become deserted"
- Laser treatment of spider veins

Foam sclerotherapy The laser beam passes through the skin without damaging it, and reaches the red spider veins, which are closed by the high energy of the light beam.

- Compression therapy, congestion adjusted

Compression therapy, congestion adjusted Munich

Compression therapy (stockings) is an important component of vein treatment. In most cases, it is necessary only during and shortly after the treatment. Just in the case of chronic congestion, such as deep state thrombosis, it is necessary to use this treatment long term.

- Operative procedures:

- Crossectomy

Ligation of incompetent truncal veins at the junction with the deep femoral veins.

Veins Crossectomy Munic

Stripping of the truncal vein

A flexible probe is inserted into the diseased vein. The varicose vein is cut through the top and bottom and is fixed to the probe. By pulling out the probe, the varicose vein is also removed.

- Phlebectomy

The varicose side branches are removed through small cuts and special instruments. In ideal cases, if the cuts do not exceed 2 to 3 mm, they can heal without scaring.

New surgical procedures

- Catheter method

Venefitprocedure (Covidien ClosureFast - licensed since 1999), ELVES laser (approved since 2001) - we use both methods since 2002.
VenaSeal adhesive technology (approved since 2011 in Germany) – we use it since 2012 as a promising future method. Lasertherapie von Besenreiser Phlebologie Krampfadern in 80331 München am Dom

These methods have become a real alternative to vein stripping surgery in recent years. The truncal veins or larger varicose veins are sealed by means of the output energy of radio waves or laser probe. For this purpose, a small incision or puncture of the skin is performed in the area of the lower leg. A very thin probe is introduced into the truncal vein, and advanced up to the inguinal area or knee. The catheter is slowly withdrawn while the vein wall is heated, the vein shrinks and it eventually closes completely. This makes the inguinal or popliteal cut obsolete.

Schaumverödung von Besenreiser Phlebologie Krampfadern in 80331 München am Dom

The vein is removed by the body later. We treat about 500 patients annually with these methods, and can confirm the benefits observed in studies:

If someone finds the "pulling method" scary, we can suggest an alternative that can be better in some circumstances than the surgical "gold standard".

More infos : oder oder

VenaSeal Sapheon Closure System

Schaumverödung von Besenreiser Phlebologie Krampfadern in 80331 München am Dom

A new and unique minimally invasive treatment of varicose veins, in which a medical adhesive is used in order to safely and effectively seal varicose veins. Through a small puncture in the skin (usually in the lower leg), a small catheter is positioned in the diseased vein under ultrasound guidance. After that, again under ultrasound guidance, a small amount of medical adhesive is gradually released in order to to seal the vein. In addition, gentle pressure is exerted from the outside. The VenaSeal adhesive was developed from cyanoacrylate glue, a special adhesive used for over 50 years in medicine, specifically developed for the treatment of varicose veins.

The advantages of this method are obvious: small amounts of narcotics (usually only at the puncture site); the usual compression therapy is obsolete or only necessary for a few days; no danger of skin or nerve injuries; occupational and sporting activities can usually be resumed the next day.

Further information under:

The costs of the catheter methods used for diseased truncal veins are assumed by all private health insuring companies and aid systems, but not by all statutory insurances. Depending on the individual clinical picture, the costs may add up to somewhere between 1200 and 2800 Euros.

CHIVA Method

Surgery methods that do not remove the veins – by the use of elaborate duplex ultrasound examination diseased vein sections are targeted and eradicated. The visible varicose veins usually regress. In some cases, however, the regression is not complete, which may lead to the necessity of further interventions.


Mainly local anesthetic techniques are used in our clinic (infiltration anesthesia, tumescent anesthesia, femoral plexus block). The advatage of these methods is that they are gentle and present only low risk. When indicated, or requested, general anesthesia may be used. When needed, post-operative patients can be observed overnight.