When should one of these procedures NOT be done on veins?
Endovenous Ablation (EVA) is administered using a catheter delivery heat through a laser (EVLT) or radiofrequency energy (RFA). EVA is usually limited to treating the Great Saphenous Vein (GSV) or the Small Saphenous Vein (SSV) when they are insufficient (no longer transporting blood as they should). These veins are often not visible or palpable but are examined by duplex ultrasound examination. If the GSV or SSV is insufficient along with Varicose Veins (which are visually apparent and palpable as bulging, protruding, tortuous, firm veins under the skin), usually EVA is administered prior to treating the Varicose Veins.
After EVA, the Varicose Veins are best treated by Sclerotherapy. An alternative to Sclerotherapy is Phlebectomy, which involves making small incisions in the skin followed by removal of small segments of the Varicose Vein. Phlebectomy leaves small scars and almost always leaves segments of the Varicose Veins behind. Sclerotherapy can remove all segments of Varicose Veins without producing any scars.
Published on Jul 11, 2012
These procedures are NOT to be done if there are no symptoms. Each procedure has its indication, to be discussed with your doctor.
Published on Jul 11, 2012
This is a question that can only be answered by the treating physician and the answer is based on whether or not there is venous insufficiency or if the vein is amenable to ablation. Ablation procedures treat venous insufficiency and should be reserved to treating refluxing vein segments. Varicose veins are treated with sclereotherapy or microphlebectomy.
Published on Jul 11, 2012
Both are different modalities. Typically EVLT is done on larger slightly deeper saphneous veins which are refluxing and causing the surface varicose veins. An experienced vascular trained surgeon can also remove some of the surface varicose veins at the same time (microphlebectomy) with very good results. In my clinic sclerotherapy is used for spider veins, deeper refluxing perforator veins and short segments of larger veins if needed. I prefer the removal of larger veins as there are less complications and visits.
Published on Jul 11, 2012
Varicose veins are due to malfunctioning of the valves of usually the saphenous system of veins. The first step in the treatment on varicose veins is to find the refluxing valves with an ultrasound. Next the valves need to be sealed then the varicose veins can be treated by sclerotherapy or removal through micro incisions. I prefer the micro incisions and reserve sclerotherapy for spider veins.
Published on Jul 11, 2012
Sclerotherapy treats spider veins only. For true varicose veins, EVLT (endovenous laser treatment) is necessary.
Published on Jul 11, 2012
EVLT is by far the best treatment for the larger veins called varicose veins. The veins must be over .4cm in diameter in order for the insurance companies to consider them medically necessary and cover the treatment.
Published on Jul 11, 2012
Endovenous laser procedures are not the treatment for varicose veins which are tortuous and close to the skin. Varicose veins can be treated by foam sclerotherapy or stab phlebectomies.
Published on Jul 11, 2012