LASER VEIN CLOSURE TREATMENT

Treatments are performed within the comfort of our office. There is no anesthesia required for this procedure. Patients remain awake during the procedure. Prior to beginning, the treatment area is first cleaned. Ultrasound is then performed again to better locate the perfect access point for the targeted vein. A small IV catheter is then placed into the vein using ultrasound guidance. A very thin laser fiber is inserted throughout the course of the vein through the catheter. This process is designed to close the entire diseased vein.

Then, liquid anesthesia known as Tumescent Anesthesia is placed around the length of the treated vein. This is to prevent pain during and following treatment. The laser fiber is then gently removed from the vein while releasing heat which then closes the vein. Once removed, the procedure is completed. The treated leg is then wrapped in a cotton wrap and custom fit stocking.

Following treatment, patients are usually permitted to drive themselves home. You will also be provided with special at-home instructions which must be followed in order to ensure a speedy and successful recovery.

In the time following treatment as the treated vein is naturally absorbed by the body, you can notice results for a clearer and vein-free complexion.

The vein that is treated by EVLT remains closed for the rest of your life, and as time passes, it gets absorbed to a certain extent by the body.

The fact of the matter is that there are already other veins that are currently directing the blood flow back to the heart because the refluxing veins are currently sending the venous blood back down the leg (when standing or sitting for a long time). When the abnormal vein is shut off, these other veins will have an easier time carrying the blood out of the leg.

An important innovation about the EVLT is that it can be performed with the patient awake. It does not require general anesthesia. It only requires local anesthesia, i.e. injections with the lidocaine-containing solution. General anesthesia is a potentially dangerous undertaking for patients, and it is completely unnecessary for this procedure.

In fact, we have performed over 2,000 EVLT’s in the past several years. We have never had to use anything more than local anesthesia to perform those procedures, even in the most anxious patients.

No stitches

We do all our EVLT procedures in one-hour sessions. We have learned from performing over 2,000 procedures that one-hour is the optimal time for completing the procedure. Beyond one hour, there arises a greater chance of issues arising from the patient’s back pain, hip pain, bladder incontinence, fatigue, etc. If you have very complex venous reflux anatomy where there are more than 2-3 veins that need to be treated, you may require two EVLT sessions.

For the same reason as above, we treat one leg at a time, ideally one month apart. Treating both legs in the same setting takes too much time and discomfort during the procedure. There is tissue trauma, post-procedural pain, and discomfort that follow each EVLT procedure, such that treating both legs simultaneously can be overwhelming for most patients.

Time off from work depends on two things: (a) Degree of physical activity required in your job that would be a stress on the newly treated leg; (b) Your desire to return to work and your ability to endure mild to moderate pain/discomfort during work. If your job consists of low-level physical activity (e.g., office work), and if you are motivated to return to work (e.g., self-employed), you can return to work the following day. Even if your job requires a moderate degree of physical activity (e.g., nurse or hairstylist), if you are able to tolerate mild to moderate discomfort (equivalent discomfort to a moderate cold or flu), then you can also return in 1-2 days.

If your job requires strenuous physical activity (e.g., construction work or mail-carrier) or if you are unable to tolerate mild or moderate discomfort well, then you should take off between 1-3 days plus the weekend and return to work the following Monday. If minimizing time-off from work is important to you, then you should let us know, and we will schedule your procedures accordingly to meet your needs.

There can be mild to moderate pain associated with post-procedural inflammation. We use low-frequency laser technology to minimize post-procedural pain. Usually, most patients tolerate pain with anti-inflammatory analgesics such as Ibuprofen alone.

The veins that we treat with EVLT will stay closed with a success rate of 95 to 98%, long-term. If your leg pain and discomfort are caused by venous insufficiency, then EVLT will result in significant improvement in pain and discomfort in over 80% of patients. If your concern is that of leg swelling, the following is what we have observed: After EVLT, the pain and discomfort and the “pressure” associated with your swelling in the leg will improve in greater than 80% of the time.

But the “disappearance” of swelling will depend on the nature of your swelling, such as the cause of your leg swelling above and beyond the refluxing veins (such as obesity, heart/liver/kidney conditions, etc.), the duration of your leg swelling, etc. In some patients, the appearance of swelling does not return to normal even though the pain and discomfort are alleviated.

The chance that the vein that was closed by EVLT will open again is less than 2-5% (1- 2% at the Advanced Vein Care Center). However, the chance that other veins in the leg will develop venous insufficiency because of on-going risk factors (hereditary, obesity, standing long periods), is about 25%. Venous insufficiency is a life-long condition, and it needs to be monitored by the patient so that when the symptoms of pain and varicose veins return, you should seek help from the vein specialist right away.