Endovenous Laser Ablation
Endovenous Laser Ablation (EVLA) is a minimally invasive alternative to the traditional ligation and stripping treatment of painful, unsightly varicose veins. Varicose veins are a common medical condition that involves weakened valves within the veins that allow blood to flow backward and form a twisted, raised growth under the surface of the skin. This condition can cause severe pain, heaviness, swelling and bleeding along with embarrassment about displaying your legs.
While ligation and stripping was once considered the primary treatment for varicose veins, it has quickly become outdated and unnecessarily invasive. Ligation and stripping was performed under general anesthesia and required up to two weeks of recovery time before patients could return to work. Many patients also experienced pain and discomfort during and after the procedure, as it involves pulling the damaged veins out through several incisions in the leg.
New technology has allowed doctors to develop less invasive alternatives such as EVLA. EVLA uses laser energy to heat damaged veins and seal them shut. This is done through a tiny incision in the leg that does not even require suturing, but still offers patients permanent, effective removal of damaged veins. EVLA is ideal for nearly any patient with large, painful varicose veins. Your doctor will perform an ultrasound exam in order to determine if this procedure is right for you. EVLA can be performed for medical or cosmetic purposes.
During the EVLA procedure, the skin is numbed with local anesthesia, and a tiny laser fiber is inserted into the skin and guided to the saphenous vein through ultrasound imaging. The vein is then surrounded by a small amount of liquid and exposed to the laser energy for approximately three minutes before the laser probe is removed. The laser energy causes the vein to be sealed off and diverts blood flow to healthier surrounding veins. The whole procedure usually takes less than an hour to perform.
Once the damaged veins are sealed off, the blood in the vein is diverted to surrounding veins and a normal blood flow is reinstated. The blood flow can function without the use of the sealed vein and may actually be improved, since a damaged vein is likely to make other veins work even harder than usual.
EVLT Procedure or endovenous laser ablation
EVLT stands for endovenous laser treatment. It is an effective method for getting rid of varicose veins, a condition caused when vein valves do not close correctly, thereby allowing blood to pool in the affected area. Veins begin to bulge as blood pushes against the vein walls. The result is painful, causing legs to ache and swell. In worse case scenarios, varicose veins can lead to unnecessary bleeding and eczema or ulceration.
1. EVLT deals with the source of varicose veins without an invasive surgical procedure like ambulatory phlebectomy, ligation and stripping or sclerotherapy. It uses a fiber laser energy probe, guided by ultrasound, to deliver impulses to the affected area. It is highly effective, working 98 percent of the time.
Non-Eligibility for EVLT
2. Patients with heart disease or blood disorders may not be eligible for this procedure. Pregnant women are not immediate candidates either since, in many cases, temporary varicose veins disappear after pregnancy.
Before EVLT Begins
3. A physician evaluation, including a medical history, physical exam and ultrasound are required before EVLT. Additionally, most physicians want to approve post surgical compression hosiery at that time. Just before the procedure, patients are asked to shower with antibacterial soap.
What to Expect
4. EVLT is done out patient and takes less than thirty minutes The patient can usually drive themselves to the office and drive home. Only a local anesthetic is given before EVLT begins. Patients are also offered a pair of protective glasses to wear. Then, a small catheter is threaded into the vein entering usually from below the knee. The laser fiber is gently advanced through the catheter and, once in place, uses its energy to seal off the vein. Then the laser fiber is removed, the wound dressed, and compression hosiery applied. The procedure is very gentle, the only discomfort felt are a few pinches during local anesthetic administration. Our newer lasers are very gentle and patients experience very little or no pain after the procedure.
5. After the procedure, the patient must walk on a treadmill for roughly 15 minutes. Activity is encouraged following the procedure. Patients cannot remove compression hosiery for five days and are allowed to bath with the Compression hosiery left on. Restrictions may be imposed, such as heavy lifting over the head and from jogging. Patients are allowed to use a tread mill, and yoga and Pilates are ok. Painkillers like ibuprofen or acetaminophen may be taken as needed, but usually are not needed. Sometimes mild stiffness and soreness are felt but usually should disappear within two weeks.
A second ultrasound may be performed at two weeks after EVLT and additional physician follow-up appointments will be made. Sclerotherapy if needed is usually started with in two weeks. Most of our patients are advised to come in for yearly ultrasound evaluations.
Recovery and Results
After the EVLA procedure, patients will be able to return home and to normal activities right away. Most patients return to work the very next day, although exercise and strenuous activity should be avoided for a few days. There is no stitching or suturing needed after this procedure either. The incision is small enough to heal on its own and leaves virtually no scarring
EVLA provides permanent removal of varicose veins through a minimally invasive procedure with no downtime. In order to maintain the results of this procedure and to prevent further damage from occurring, patients are encouraged to lose weight and engage in a healthy and active life.
While EVLA is generally considered safe, there are certain risks associated with any surgical procedure. Some of these risks include infection, bruising, bleeding, clotting, puncturing and thermal damage. These risks are considered rare and most patients undergo the procedure with no complications.
If you are interested in learning more about EVLA, please call us to schedule a consultation. There is no reason for you to be living with painful, unsightly varicose veins any longer, and relief is now available through a safe, minimally invasive procedure.
VNUS CLOSURE FAST
We also offer Vnus closure fast procedures at California Vein Specialists. This procedure is performed the same way as the Endovenus Laser Ablation, but the energy source comes from radio frequency instead of a laser source. Over the years VNUS closure has become as reliable and as gentle as the newest laser wave lengths. The main disadvantage of the closure fast system is that it is expense; it costs more to perform the procedure due to the high cost of its catheter.