EndoVenous Laser Treatment (EVLT™)
Do you suffer from varicose veins? Do your legs feel painful,
heavy and swollen at the end of the day? Perhaps you have sought treatment,
but do not want to undergo the painful surgical stripping procedure?
Now you don't have to suffer from it any longer!
The clinical name given to the medical procedure is EndoVenous Laser
Treatment or EVLT™. This deals with the most common underlying
cause of varicose veins which is incompetence of the greater saphenous
veins. Unlike surgical stripping, EVLT permanently closes off the vein
while leaving it in place. It uses the energy from an 810 nm diode laser delivered
by a fine fiber-optic probe.As it is only the probe and a slim sheath
which need to enter the vein the whole procedure is performed via a tiny
skin nick, so there will be no post operative scarring.The probe is guided
into place using ultrasound and the procedure is performed under strictly
local anesthetic of a similar type used by dentist to numb the treatment
area.
Veins carry blood from the tissues back eventually to the heart. They
are thin walled tubes which get squeezed by the surrounding muscles as
they contract. This squeezing forces blood along the veins and a series
of non-return valves ensure the flow is only in one direction.
If these valves become faulty and fail to close the flood can run backwards
(or reflux) and will father or pool in the legs. Where this extra blood
is sitting in veins close to the surface of the skin, the veins will
swell up and become visible and 'varicosed'.
There is one major vein (the greater saphenous vein), which connects
to many of the surface superficial veins. Failure of the valves in this
vein is quite common and is therefore a major cause of surface varicose
veins. This vein runs down from the groin to the lower leg and the faulty
valves are often up near the top. Hence varicose veins in the lower thigh,
around the knee and in the calf are often caused by a problem much higher
up.
How does the procedure actually work?
The laser energy damages the vein walls, shrinking them and thus closing
the faulty vein so that the blood can no longer flow through it.
Is loss of this vein a problem?
No. There are many veins in the leg and after treatment the blood in
the faulty veins will be diverted to normal veins in order to make
its way back to the heart.
What are the complications of this procedure?
There are potential complications with any medical procedure however
the only minimal complications experienced with the EVLT™ Procedure
have been a small number of cases of transient paresthesia (numbness).
Am I at risk from the laser?
No. You will be given a pair of special glasses to wear to protect your
eyes, however this is just a precaution.
What is the alternative to this treatment?
Traditionally faulty Saphenous veins have been treated with surgical
ligation and stripping. This involves at least two surgical incisions
in order to tie off and pull out the faulty vein. It is usually performed
under general anesthesia. EVLT™ appears to have lower risk; shorter
recovery period, lower costs and no scarring compared with surgery.
Are there alternative minimally invasive treatments available?
Yes. The two common ones are ultrasound-guided sclerotherapy (injection
therapy) and radio frequency electrosurgery. Injection therapy for
the Saphenous vein appears to have a high recurrence rate frequently
requiring retreatment. However it is excellent for cosmetic treatment
of any visible veins remaining after EVLT™.
Radiofrequency electrosurgery is more limited in the range of patients
it can treat and the treatment time is longer than EVLT™.
How successful is EVLT™?
Early results have been extremely favorable with success rates as high
as the conventional surgical approach, which is accepted as the 'gold
standard' treatment. EVLT™ will normally treat the cause of most
varicose veins but additional/complimentary therapy may be necessary
in some cases.
Practicing Physician
Mahmood Tahir, M.D.
451 Chew Street, Allentown, PA 18102
610-821-9356
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