Varicose veins are abnormally swollen (dilated) and tortous (twisted) veins. Varicose veins are usually situated quite near the surface and are often visible beneath the skin. Varicose veins can vary in size from quite small (2-3mm across) to very large (2-3cms across). Very small veins are called “thread veins” or “spider veins”. These veins are different to varicose veins because they are situated much closer or within the overlying skin. Although they may be unsightly, they are not the same as varicose veins and can be more difficult to treat. Reticular veins are obvious varicose veins which are present beneath the skin and easily visible, but rather smaller than the larger knobbly veins. Reticular veins may only bulge the skin slightly if at all, whereas varicose veins tend to produce marked bulging of the skin.

What causes varicose veins?

Veins are blood vessels that normally return blood from the leg upwards, back to the heart. Blood flow in the veins should also always travel from the superficial veins to the deeper veins in the legs. Blood will not normally travel downwards in the reverse direction or outwards from deep to superficial veins as there are one-way valves inside the veins that prevent this occurring . In some people faults can develop in these valves (we do not know why for most), and blood is permitted to travel not only towards the heart, but can also travel backwards (reflux) towards the foot, especially on standing. Veins that reflux are said to be incompetent or to have incompetent valves.


Endovenous laser treatment is a minimally invasive technique to destroy the greater saphenous vein (GSV) in the thigh and/or the small saphenous vein (SSV) at the back of the calf. Laser is an acronym and stands for “Light Amplification by Stimulated Emission of Radiation. Laser light is monochromatic (single wavelength) light produced from a laser medium and then amplified to produce a powerful beam There are at least 5 types of laser available all with the supporters and detractors. The different lasers vary in the wavelength of the laser light produced and there are some theoretical advantages and disadvantages of each of these different types of lasers. There is little evidence to support one laser over another and there is no level 1 evidence from blinded randomised trials. Presently there are lasers working at 810, 940, 980, 1320 and 1470nm. EVLT™ is a particular brand of device that is used for EVLA.

When are EVLA used in the treatment of varicose veins? 

EVLA sound impressive, but they are merely alternative techniques that can be used to destroy the greater saphenous vein in the thigh or the small saphenous vein at the back of the calf. EVLA are alternatives to stripping veins and also replace the disconnection of veins performed through a small incision either in the groin or behind the knee (saphenofemoral and saphenopopliteal disconnection). In sclerotherapy chemical foam is injected to damage the vein. In EVLT the veins are destroyed by heating them to a high enough temperature to damage the vein wall.

Should I have EVLA to treat my varicose veins?

Suitable patients being treated with EVLA will generally have greater saphenous vein (along thigh) and or small saphenous vein (back of calf) reflux. They will need a vein that is reasonably straight in order to pass the laser fibre catheter up the vein. It is also important that fluid can be injected around the vein to separate it from the skin and surrounding structures so they do not get burned, but this is a very unlikely event.



Sclerotherapy or injection of varicose veins is a procedure designed to improve the appearance of your varicose veins. The veins are injected with a solution called a sclerosant which damages the internal lining of the vein and causes blood clotting within the vein. In time, your own body will then destroy the vein and it will disappear. The solution normally used for this procedure is called sodium tetradecyl sulphate (STD) and is available in different concentrations depending on the size of the vein being treated. Normally STD is injected as a solution directly into the vein to be treated. Foam sclerotherapy involves making small volumes of the solution into foam by rapid mixing and agitation with a small volume of air. This can then be used to treat some of the larger underlying abnormal veins which would not normally be treated with conventional sclerotherapy.

Spider Veins laser Schlerotherapy-Surface Laser Treatment

These red, blue or purple thread-like lines may develop on any part of the body, including the face, but most often appear on the thighs, calves, or buttocks. The condition is associated with increased pressure to the veins. The gold standard treatment for spider veins is laser. Laser vein removal is an easy, fast, and effective way to treat superficial veins Laser therapy has been used in the medicine for more than 30 years. Advances in technology have helped developed many different lasers. The laser uses a focused beam of light. In the treatment of veins, the wavelength of light is targeted to the pigment in the blood. The laser heats up the small vein and destroys it. The laser beam is focused and does not damage the nearby skin tissue. Over a period of four to six weeks, the vein is reabsorbed by the body and disappears.

My clinical practice

  • Varicose Veins Endovenous Laser Ablation
  • Varicose Vein Surgery
  • Varicose Veins Foam Sclerotherapy
  • Spider veins Foam Sclerotherapy
  • Spider Veins Laser Sclerotherapy
  • Deep Vein Thrombosis Pharmacomechanical Thrombectomy
  • Deep Vein Thrombosis Medical Treatment
  • Arterial Embolism Thrombectomy
  • Chronic venous insufficiency and leg ulcers treatment
  • Inferior Vena Cava Filter Placement
  • Arteriovenous a-v fistula for hemodialysis
  • Central catheters insertion for acute and chronic hemodialysis access
  • Trombophlebitis Treatment
  • Treating Lymphoedema- Decongestive Lymphatic Therapy (DLT)
  • EVAR
  • Peripheral Arterial Dissease
  • Angioplasty and Stenting
  • Endarterectomy
  • Surgical Peripheric Arterial Bypass

Contact Us

E-Mail:     bilgi@drilkerzan.com
Phone:        (
0090)242 510 2525 
WhatsApp:  (
0090)532 474 6510

ilker zan M.D

Baskent University  Hospital


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Associations as members:

Turkish National Vascular and Endovascular Surgery Assosiation
European Society For Vascular Surgery (www.esvs.org)
Turkish National Cardiovascular SUrgery Assosiation (www.tkdcd.org)