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If the evlt procedure doesn't alleviate problems in the lower leg do /can you laser the lower leg?
Because the greater saphenous at calf level is in most segments attached to the nerve (sup. saphenous nerve), and the high temprature generate by the laser, can damage that nerve, resulting in permanent numbness on inner aspect of calf. Furthermore, in the case of greater saphenous vein varicosity, usually, there are multiple accessory branches of that vein that are varicose. Laser cannot treat these side branches, while other treatments, such as foam-sclerotherapy work well, after the upper part of greater spahenous vein in treated by endovenous laser ablation first.
It can be done in the lower leg but generally the problem is in the thigh vein which is the source of the varices.
Endovenous ablation below the knee has a higher incidence of nerve injury and that is why most ablations of the greater saphenous vein are done above the knee.
Endovenous thermal ablation, either by LASER or radiofrequency, can be done to occlude nearly any vein which is straight enough to pass the device up the vein. There is a higher risk of injury to a nerve near the greater saphenous vein in the calf than there is when the treatment is limited to the thigh. This is a sensory nerve providing sensation to some of the skin of the leg. This usually is not a major problem. Many phlebologists selectively use endovenous thermal ablation for the great saphenous vein in the calf or for the small saphenous vein. The devices cannot be passed up varicose veins with significant curves, so other techniques such as foam sclerotherapy or microphlebectomy are used for these veins.
Yes, if there is a refluxing (leaking) vein, it can be treated.
EVLT is a procedure that is highly effective to aleviate leg pain due to venous insufficiency. Most of the? patients obtain a great deal of relief by having just the greater saphenous vein treated (upper leg).
For some patients, that is not enough. In these patients if they have insufficiency of the Lesser saphenous vein we can also use EVLT to treat that vein and?can be?effective.
Other patients we use EVLT to treat "perforator veins" in the calf.
Still others that we cannot use EVLT due to their particular anatomy we use other methods to relief the symptoms.
EVLT is the acronym for laser treatment of the veins. The laser seals the vein with heat. If the laser is performed on the vein in the thigh segment, the segment below the knee may still be open and leaky. Consider having another ultrasound to see if the vein below the knee is still leaking. If it is, then the laser can be used to seal this lower segment.
Endovenous laser ablation can be used for the lower leg. The reason it is stopped around the knee is because the saphenous nerve is very close to the saphenous vein from the knee down and can be injured by the laser. Usually from the knee down this can be treated with foam sclerotherapy. For significant reflux and especially for chronic venous insufficiency, I laser to almost the ankle.
Yes you can laser in the lower leg, you have to be much more careful. There is a nerve that supplies sensation to the skin, saphenous nerve, that runs along the vein in the lower leg. The heat can damage the nerve and you can get temporary numbness or permanent numbness from this. Sometimes this is avoidable if enough tumescent is used however sometimes regardless of how good your technique is the nerve can still be damaged.