If you have varicose veins, you may be a candidate for EVLT. To find out whether you might benefit from EVLT, call our office to schedule a consultation with one of our physicians to assess your treatment options. You will then have an ultrasound exam of your veins for proper diagnosis of your venous condition.
This procedure is performed under local anesthesia in our comfortable outpatient environment. While you might feel some unfamiliar sensations, the procedure for most people produces only a mild degree of pain or discomfort. Using ultrasound, the physician maps out the vein(s) to be treated with a marker. The leg is then washed and prepared for sterile procedure. Similar to an IV, a catheter is placed inside the vein while using ultrasound guidance. Since there are no nerves in the veins, patients do not feel this occurring. The laser probe is then inserted inside the catheter. A local anesthetic is then administered around the vein to protect the surrounding body tissues. The laser energy is delivered as the fiber is slowly withdrawn. This causes the vein to collapse and eventually dissolve into surrounding body tissue.
Controlled laser energy is delivered to the inside of the damaged vein. This energy damages the vein walls, shrinking and closing the diseased vein, preventing blood flow and further reflux. Following treatment, blood will be diverted to normal veins in order to make its way back to the heart. This redistribution of blood flow should improve blood circulation in the treated area. Improvement in circulation results in a reduction of the symptoms of fatigue and heaviness in the area.
Following the procedure, Steri-Strips, dressing, compression stockings, and a compression wrap are placed on the treated leg. You will be asked to walk for at least 20 minutes immediately following your treatment. The medical grade compression stockings will need to be worn for the first 36 hours and then about two weeks following the procedure to achieve maximum healing and results. Most people are able to return to normal activities of daily living immediately, although, strenuous activities, such as exercise, will be limited for approximately one to two weeks to promote healing. It is common to have some discomfort and bruising after this procedure. Discomfort is usually managed by an over-the-counter, non-aspirin pain reliever.
As with all medical procedures, there are some risks associated with EVLT. There is a small risk of bleeding, infection, allergic reaction to local anesthetic, and injury to other tissues. These risks are quite small. Any type of venous intervention can be associated with blood clot formation. While the occurrence of this is rare, a clot does have the potential to spread to the main vein in your leg. Your physician will check for this at a follow-up appointment using color flow ultrasound. Our physicians have had less than 1% of their treated patients develop this problem, and it is generally treated with blood thinning medications.
Many insurance carriers (including Medicare) do provide coverage for EVLT. Unfortunately, not everyone is a candidate for coverage. Carriers will cover the procedure only when deemed medically necessary. Patients must demonstrate symptomatic venous reflux disease to be considered for coverage. Symptoms associated with venous reflux disease are: pain, swelling, leg cramps, ulcers, bleeding from varicosities, etc. Patients are also required to try conservative treatment, such as compression stockings, before being considered for coverage. Insurance companies will also want to see ultrasound results to determine the presence of reflux in the diseased vein(s). You may find it helpful to contact your insurance company if you have further questions about coverage.