I had EVLT preformed 3 weeks ago. When I went for the 2 week follow-up ultrasound it showed that the vein was still open and doctor said he needed to redo the procedure. Please advise - I thought this was a one-time procedure.
95% closure rate. May want to discuss with the treating physician.
David A. Engleman M.D.
Published on Jul 11, 2012
An EVLT is usually, 98% to 99%, a one time treatment . That is 98-99% the
vein is closed and stays closed for at least several years, that is as long
as we have data for, maybe for ever.
Redo procedure do occur but they should be uncommon.
Published on Jul 11, 2012
While this possible, it is very rare. Using enough laser energy for the size of the vein will seal a saphenous vein.
It is critical to ensure, using ultrasound, that the fiber is the vein and the catheter An experienced board certified surgeon is essential. I would recommend waiting for 6-9 weeks.
Norman N Bein MD FACS
Published on Jul 11, 2012
EVLT is a very highly succesful procedure. However as with anything else in medicine, occasionally does not work as predicted. There is a small number of patients in which the procedure needs to be done again. There is a number of factors that can produce a failure of the original procedure and that includes: the size of the vein, the amount of energy delivery, patient compliance with stockings post-procedure, etc.
The good thing is that it is a relatively easy procedure and it can be re-done safely. With some extra precautions and changes on the technique, the second time around it is possible to secure a succesful procedure.
Rodolfo D. Farhy, MD, FACC, FAHA
Published on Jul 11, 2012
Very rarely does this procedure fail but when it does in the first month or
2 (especially in the first 2 weeks) I attribute it to a bad laser fiber. I
will redo the procedure (at no extra cost to the patient or insurance) and
increase the wattage on the laser and retract the laser a slower rate
(delivering more energy/cm to the vein).
Published on Jul 11, 2012
Rarely the ablated vein does not close. Options for treatment are reclosure with laser or radio frequency ( or even surgical ligation) I generally try the other modality when a vein doesn't close, but reclosure with laser is a reasonable option.
Michael D. Ingegno
Published on Jul 11, 2012
This is not a clear cut answer. Certainly, the treated vein should be closed at the 2 week point. I would like to know if the entire treated vein is open or only certain areas. Also, is it partially or totally open? Sometimes ultrasound guided sclerotherapy may help to close the remainder of the vein and sometimes the veins may close over more time. I would consider ultrasonic guided sclerotherapy and allowing another 4 weeks before rushing to redo the closure. If, after 6 weeks, the vein is still open, then reconsider another closure procedure.
Published on Jul 11, 2012