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Can endovenous laser ablation be used to treat multiple veins, or only the greater saphenous vein? Will it take care of varicose veins that are closer to my ankles?
No. As of now (October 2009), endovenous laser ablations are FDA-
approved only for treatment of greater saphenous varicosity, and to
avoid damage to saphenous nerve, it is done for the thigh segment of
greater saphenous varicosity. For the calf segment of greater
saphenous vein, foam sclerotherapy can be done after closing the thigh
level of same vein. This is a great combination therapy, which is
done in two sessions by most phlebologists. First, Laser ablation of
the greater saphenous vein is done (in the doctor's office usually),
then in 1-2 weeks the lower parts of varicosity of greater saphenous
is treated by other methods (most commonly and successfully by foam-
Endovenous laser is used for treatment of the feeder veins to the surface varices. The treatment can be used to treat various sizes and shapes of feeder veins, however the more visible veins are usually treated with microphlebectomy, or sclerotherapy depending on MD preference.
ELT will treat veins other than the Saphenous. However, most veins lower in the leg must be treated with sclerotherapy or vein stripping. The ELT treats the larger sources of the problem, but is often impractical when dealing with twisty, small veins, especially on the very low leg or ankle.
EVLT is usually used on the Greater Saphenous Veins (GSV) but can also be used on other veins including the the Small (lesser) Saphenous Vein (SSV) or incompetent perforator veins.
Not all veins however are best closed with EVLT and this is decided on a vein by vein basis, depending on it's size, depth, tortuosity etc.
As far as your ankle veins are concerned it depends on the cause. An ultrasound and venous mapping study can usually determine the cause of them.
The ablation is performed on the vein that is the source of the venous
insufficiency. This is usually the greater saphenous vein, but not
always. The branches off of the insufficient vein are usually what is
visible and in your case are the veins around your ankle. These veins
usually get smaller and don't bulge after an ablation, but may also be
treated with microphlebectomy.
Endovenous laser ablation is used to treat the cause of the varicose veins and can be used to treat many veins. The varicose veins typically need to be treated either by microphlebectomy or sclerotherapy.
Endovenous laser is used primarily to treat reflux on the greater and lesser saphenous veins. Can be used to treat some branches called perforators. Cannot be used to treat superficial veins directly like the ones you describe on the ankles.
EVLT can treat the saphenous veins and perforator veins. You will find that many of the superficial varicose veins below the treated vein segments will decrease in size over time.
ELA can be used on multiple veins including the greater and smaller saphenous veins, accessory veins and perforators. The vein should have reflux, be straight and big enough to accommodate the laser fiber. Smaller veins are best treated by microphlebectomies or sclerotherapy.
Endovenous Laser Ablation ELA will treat veins other than the Saphenous. However, most veins lower in the leg must be treated with sclerotherapy or vein stripping. The ELA treats the larger sources of the problem, but is often impractical when dealing with twisty, small veins, especially on the very low leg or ankle.