How effective are EVLT and ultrasound-guided sclerotherapy? What's the chance the vein will reopen?

I am considering EVLT and ultrasound-guided sclerotherapy based on my doctor's recommendation. How effective are the procedures? What's the chance the vein will reopen? He will be treating the GS and LS in both legs in one session. Is this too much in one day?

Answers from doctors (7)


Vein Specialties of St. Louis

Published on Aug 04, 2014

I do not treat both GSV and SSV in one session. I feel that this is too much local anesthetic and time for the patients. I would treat the GSV and also do microphlebectomy for varicose veins if present. The bulging veins will be gone. Sclerotherapy for larger vessels involves several treatment and additional treatments for removing trapped blood. I am a Board Certified Surgeon and feel this offers the least inconvenience for my patients as well as excellent cosmetic results. Sclerotherapy is fine for small veins or perforator veins using ultrasound guidance.
With appropriate treatment and follow-up we have few veins re-opening. However, this is considered a "chronic" problem and you could possibly develop problems in the future.

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Answered by Vein Specialties of St. Louis

I do not treat both GSV and SSV in one session. I feel that this is too much local anesthetic and time for the patients. I would treat the GSV and also do microphlebectomy for varicose veins if present. The bulging veins will be gone. Sclerotherapy for larger vessels involves several treatment and additional treatments for removing trapped blood. I am a Board Certified Surgeon and feel this offers the least inconvenience for my patients as well as excellent cosmetic results. Sclerotherapy is fine for small veins or perforator veins using ultrasound guidance.
With appropriate treatment and follow-up we have few veins re-opening. However, this is considered a "chronic" problem and you could possibly develop problems in the future.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Jul 29, 2014

If you are treating all four veins with an ablation, especially with laser, then I would not recommend doing them all in one session. The amount of lidocaine being used to numb you up for all four would exceed a safe amount. Another thing is sometimes the smaller saphenous (lesser saphenous) veins correct themselves without treatment after treating the greater saphenous veins. Make sure your physician is accredited by the American College of Phlebology.

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Answered by Intermountain Vein Center

If you are treating all four veins with an ablation, especially with laser, then I would not recommend doing them all in one session. The amount of lidocaine being used to numb you up for all four would exceed a safe amount. Another thing is sometimes the smaller saphenous (lesser saphenous) veins correct themselves without treatment after treating the greater saphenous veins. Make sure your physician is accredited by the American College of Phlebology.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Jul 28, 2014

In expert hands, EVLT generally has a 95% success rate regardless of vein size, while UGS has between 50-80% success depending on vein size. Treating both saphenous veins in both legs in one session would exceed the maximum allowable dose of medication with UGS and will not be possible, but should not be a problem with EVLA.

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Answered by Vein Center of Orange County

In expert hands, EVLT generally has a 95% success rate regardless of vein size, while UGS has between 50-80% success depending on vein size. Treating both saphenous veins in both legs in one session would exceed the maximum allowable dose of medication with UGS and will not be possible, but should not be a problem with EVLA.

Published on Jul 11, 2012


Lone Star Vein Center

Published on Jul 28, 2014

The procedures, in general, are very effective for treating chronic venous
insufficiency. Once the vein is ablated, it will not 're-open'. However,
you may have other diseased veins that become visible through ultrasound at a later date. You are most likely referring to the GSV and SSV (greater and short saphenous) in both legs. There are many different approaches to a treatment plan, and they may involve spacing the procedures out or performing them all at once. If you have concerns about having both legs treated in one session, speak to the specialist.

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Answered by Lone Star Vein Center

The procedures, in general, are very effective for treating chronic venous
insufficiency. Once the vein is ablated, it will not 're-open'. However,
you may have other diseased veins that become visible through ultrasound at a later date. You are most likely referring to the GSV and SSV (greater and short saphenous) in both legs. There are many different approaches to a treatment plan, and they may involve spacing the procedures out or performing them all at once. If you have concerns about having both legs treated in one session, speak to the specialist.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Jul 27, 2014

The EVLT is about 95% successful at keeping the saphenous vein closed for at least 3 years and usually much longer. Ultrasound guided sclerotherapy has about a 50% closure rate with one treatment. There are slightly increase risks with treating multiple saphenous veins in
one session, but it is done quite commonly.

Answered by Laser Vein Center (View Profile)

The EVLT is about 95% successful at keeping the saphenous vein closed for at least 3 years and usually much longer. Ultrasound guided sclerotherapy has about a 50% closure rate with one treatment. There are slightly increase risks with treating multiple saphenous veins in
one session, but it is done quite commonly.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Jul 27, 2014

Those treatments are effective, but you probably don't need all those operations and not on the same day. A second opinion is a good idea.

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Answered by Cosmetic Vein Centers of Texas

Those treatments are effective, but you probably don't need all those operations and not on the same day. A second opinion is a good idea.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jul 25, 2014

The procedures proposed are very acceptable for your problem and they carry a high success rate. EVLT has a closure rate of over 98 percent at two years. Ultrasound-guided sclerotherapy is frequently used to treat varicose veins but microphlebectomy has a lower recurrence rate. I rarely do GSV and SSV on the same day.

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Answered by Vanish Vein and Laser Center

The procedures proposed are very acceptable for your problem and they carry a high success rate. EVLT has a closure rate of over 98 percent at two years. Ultrasound-guided sclerotherapy is frequently used to treat varicose veins but microphlebectomy has a lower recurrence rate. I rarely do GSV and SSV on the same day.

Published on Jul 11, 2012


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