Need to decide between VNUS closure and Endo Laser Ablation

Endovenous Laser Ablation . 9 answers . 3 years ago

I had my large saphenous vein removed and now I need my smaller saphenous vein removed in R/L and large saphenous in L/L. I Have 2 good doctors and have read that vnus has less bruising. Is it better than ELT?

ANSWERS FROM DOCTORS


2 years ago by General Vascular Surgery Group

I've done hundreds of both procedures and tend to use the VNUS a bit more now as there is a bit less bruising and soreness post op. That said some veins are shorter or smaller and better treated with the laser.

Depends a bit on your veins but both work well.

Michael D. Ingegno

2 years ago by General Vascular Surgery Group (View Profile)

I've done hundreds of both procedures and tend to use the VNUS a bit more now as there is a bit less bruising and soreness post op. That said some veins are shorter or smaller and better treated with the laser.

Depends a bit on your veins but both work well.

Michael D. Ingegno


2 years ago by Arizona Vein and Laser Institute & Cosmetic Surgery

Your doctors should be able to explain to you the
advantages/disadvantages of both procedures. With extensive experience
of both, my clinic has a better success rate with laser.

2 years ago by Arizona Vein and Laser Institute & Cosmetic Surgery (View Profile)

Your doctors should be able to explain to you the
advantages/disadvantages of both procedures. With extensive experience
of both, my clinic has a better success rate with laser.


2 years ago by Center for Venous Disease - Santa Fe

Is your doctor board certified in Phlebology (venous disease)? VNUS is clinically superior with less post-procedure bruising and less pain. Thanks.

James A. Heinz-M.A.H.A.

2 years ago by Center for Venous Disease - Santa Fe (View Profile)

Is your doctor board certified in Phlebology (venous disease)? VNUS is clinically superior with less post-procedure bruising and less pain. Thanks.

James A. Heinz-M.A.H.A.


2 years ago by Vein Specialties of St. Louis

The answer to your question is to find a provider who has experience in either EVLA or RF. Ask how many cases they have done.

In the right hands there is minimal bruising with either procedure. Also factor in that some people bruise more than others. Some people have more inflamed veins and therefore need more local anesthesia injected which can contribute to bruising.

The lesser saphenous typically has little bruising or discomfort associated with EVLA.
Statistically Radio Frequency had a slightly higher risk of deep vein clotting but with newer equipment this seems to be improving.

Norman N. Bein MD FACS RVT

2 years ago by Vein Specialties of St. Louis (View Profile)

The answer to your question is to find a provider who has experience in either EVLA or RF. Ask how many cases they have done.

In the right hands there is minimal bruising with either procedure. Also factor in that some people bruise more than others. Some people have more inflamed veins and therefore need more local anesthesia injected which can contribute to bruising.

The lesser saphenous typically has little bruising or discomfort associated with EVLA.
Statistically Radio Frequency had a slightly higher risk of deep vein clotting but with newer equipment this seems to be improving.

Norman N. Bein MD FACS RVT


2 years ago by Angelo N. Makris MD

The results are the same, but RF VNUS has been shown to have less post-procedure pain and bruising compared to ELT.

2 years ago by Angelo N. Makris MD (View Profile)

The results are the same, but RF VNUS has been shown to have less post-procedure pain and bruising compared to ELT.


2 years ago by Heart and Vein Center

Both systems are equaly effective. There is one study suggesting slight less post procedure pain with VNUS than EVLT. On the other hand it seems that EVLT might be slightly more effective on keeping the veins closed after one year.

If the vein is large in caliber both systems will be fine. If the vein is small occasionally could be difficult to use VNUS.

VNUS does not have indication (although can be used) for small saphenous veins.

Dr Farhy

2 years ago by Heart and Vein Center (View Profile)

Both systems are equaly effective. There is one study suggesting slight less post procedure pain with VNUS than EVLT. On the other hand it seems that EVLT might be slightly more effective on keeping the veins closed after one year.

If the vein is large in caliber both systems will be fine. If the vein is small occasionally could be difficult to use VNUS.

VNUS does not have indication (although can be used) for small saphenous veins.

Dr Farhy


2 years ago by Vein Specialists

My personal preference is to use laser for the small saphenous vein since
this vein is usually smaller than the great saphenous and has the sural
nerve entwined. I find that the RF causes more paresthesias and
dysesthesias than the laser. I offer both technologies so it is really no
difference in terms of the practice revenue. Please understand that either
procedure does not remove the vein, they close the vein with heat like
cooking it and shrinking it closed. Hope this helps.

2 years ago by Vein Specialists (View Profile)

My personal preference is to use laser for the small saphenous vein since
this vein is usually smaller than the great saphenous and has the sural
nerve entwined. I find that the RF causes more paresthesias and
dysesthesias than the laser. I offer both technologies so it is really no
difference in terms of the practice revenue. Please understand that either
procedure does not remove the vein, they close the vein with heat like
cooking it and shrinking it closed. Hope this helps.


3 years ago by Vanish Vein and Laser Center

EVLT and VNUS work equally well and their use is usually physician preference. Vnus claims that their catheter causes less bruising but my experience is that there is very little difference between the two. I also feel that EVLT is technically easier, can get into smaller veins and has better long term results.

3 years ago by Vanish Vein and Laser Center (View Profile)

EVLT and VNUS work equally well and their use is usually physician preference. Vnus claims that their catheter causes less bruising but my experience is that there is very little difference between the two. I also feel that EVLT is technically easier, can get into smaller veins and has better long term results.


3 years ago by North Country Thoracic & Vascular

The VNUS procedure is done at a much lower temperature with equal results and, therefore, has less bruising. The Closure Fast catheter does require a longer vein segment than laser so that needs to be taken into account for the short saphenous vein. We use VNUS exclusively and have had no problems but if your short saphenous is really short than laser may be a better option.

3 years ago by North Country Thoracic & Vascular (View Profile)

The VNUS procedure is done at a much lower temperature with equal results and, therefore, has less bruising. The Closure Fast catheter does require a longer vein segment than laser so that needs to be taken into account for the short saphenous vein. We use VNUS exclusively and have had no problems but if your short saphenous is really short than laser may be a better option.


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