My 2 year old ultrasound study results were vague. It suggested EVLT. Is there a less invasive treatment?

Original results from a 2 year old ultrasound said right gsv positive for dilation & venous insufficiency, greater than 2 seconds at junction, symptoms are mild now, but one unsightly varicose vein at top of right inner thigh, about 5mm. I still don't want an EVLT, I’d prefer something less invasive. Also, how do they determine that it's not from pelvic origin or long term constipation/hemorrhoid pressure during a new Doppler/ultrasound study?

Answers from doctors (6)


Advanced Vein Center

Published on Jul 21, 2015

I think you are looking at this the wrong way. EVLT is not particularly invasive and is one of the safest medical treatments there are, with a very very low complication rate. On the other hand if you only have "mild symptoms" then you can do nothing or wear compression hose.

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Answered by Advanced Vein Center

I think you are looking at this the wrong way. EVLT is not particularly invasive and is one of the safest medical treatments there are, with a very very low complication rate. On the other hand if you only have "mild symptoms" then you can do nothing or wear compression hose.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Jul 14, 2015

EVLT is a minimally invasive treatment for sealing a saphenous vein which refluxes (backflow due to broken valves). It involves a small puncture in the knee area to insert a small catheter. A few local anesthetic injections and it is finished in less than 30 minutes.
There are newer procedures now FDA approved but not covered by insurance but all involve inserting some sort of catheter.
I would recommend you consult with a Board Certified Vascular Surgeon who specializes in venous problems for another evaluation. With the mild symptoms it is unlikely to be pelvic in origin but ultrasound will be able to find the source.

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Answered by Vein Specialties of St. Louis

EVLT is a minimally invasive treatment for sealing a saphenous vein which refluxes (backflow due to broken valves). It involves a small puncture in the knee area to insert a small catheter. A few local anesthetic injections and it is finished in less than 30 minutes.
There are newer procedures now FDA approved but not covered by insurance but all involve inserting some sort of catheter.
I would recommend you consult with a Board Certified Vascular Surgeon who specializes in venous problems for another evaluation. With the mild symptoms it is unlikely to be pelvic in origin but ultrasound will be able to find the source.

Published on Jul 11, 2012


More About Doctor St. Louis Vein Center

Published on Jul 14, 2015

The bottom line is there are less invasive options to treat varicose veins than an EVLT. If you have few or very mild symptoms you dont have to do anything. I recommend discussing the options with your doctor.

Answered by St. Louis Vein Center (View Profile)

The bottom line is there are less invasive options to treat varicose veins than an EVLT. If you have few or very mild symptoms you dont have to do anything. I recommend discussing the options with your doctor.

Published on Jul 11, 2012


More About Doctor Vein Center for Women PC

Published on Jul 14, 2015

Your best best would be to reevaluate the status of your legs with a more recent Ultrasound. A lot can change in a year- let alone 2. So start with a reevaluation of your legs. And as far as to rule out that it isnt coming from the pelvic region- the iliac veins are usually visualized with a ultrasound or even a CT scan. Once you can see the actual size of the vessel that needs to be treated then you can discuss other options that may be available to you. There are other procedures out there that mimic the EVLT for the most part with less post operative bruising called the venous closure, and then there is also a newer technology called CLARIVEIN that may also be an option for you; As far as insurance coverage- the only one that recognizes this as a code is medicare at the present time. It is minimally invasive and uses both a mechanico and chemical combination to shut down the incompetent vein. Its essentially "rotor rooter" for your leg. A sclerosing agent is used to create a foam and then a catheter wire is rotated/ spun while delivering the foam to shut down this vein. This usually is a faster- less invasive procedure with the same post operative results. Ask your doctor about the different options available to you.
Good luck

Answered by Vein Center for Women PC (View Profile)

Your best best would be to reevaluate the status of your legs with a more recent Ultrasound. A lot can change in a year- let alone 2. So start with a reevaluation of your legs. And as far as to rule out that it isnt coming from the pelvic region- the iliac veins are usually visualized with a ultrasound or even a CT scan. Once you can see the actual size of the vessel that needs to be treated then you can discuss other options that may be available to you. There are other procedures out there that mimic the EVLT for the most part with less post operative bruising called the venous closure, and then there is also a newer technology called CLARIVEIN that may also be an option for you; As far as insurance coverage- the only one that recognizes this as a code is medicare at the present time. It is minimally invasive and uses both a mechanico and chemical combination to shut down the incompetent vein. Its essentially "rotor rooter" for your leg. A sclerosing agent is used to create a foam and then a catheter wire is rotated/ spun while delivering the foam to shut down this vein. This usually is a faster- less invasive procedure with the same post operative results. Ask your doctor about the different options available to you.
Good luck

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jul 14, 2015

If it is 2 years since your last ultrasound then you should have the venous ultrasound repeated. If you have an inner t upper thigh varicose vein, most likely it is originating from a refluxing valve in the greater saphenous vein. If you do not have vulva or posterior upper thigh varicosities then it would be unlikely that the source is in the pelvis. Alternatives to EVLT would be Clarivein, Varithena or even ultrasonic guided sclerotherapy.

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Answered by Vanish Vein and Laser Center

If it is 2 years since your last ultrasound then you should have the venous ultrasound repeated. If you have an inner t upper thigh varicose vein, most likely it is originating from a refluxing valve in the greater saphenous vein. If you do not have vulva or posterior upper thigh varicosities then it would be unlikely that the source is in the pelvis. Alternatives to EVLT would be Clarivein, Varithena or even ultrasonic guided sclerotherapy.

Published on Jul 11, 2012


Once you have a positive study for venous insufficiency from an ICAVL accredited vascular lab it will always stay positive. Venous ablation is recommended for patients who fail medical management with compression stocking therapy and continue to be symptomatic from pain, achiness, or leg swelling. Stab phlebectomy is performed for larger bulging varicosities.

Answered by Vascular Center and Vein Clinic of Southern Indiana (View Profile)

Once you have a positive study for venous insufficiency from an ICAVL accredited vascular lab it will always stay positive. Venous ablation is recommended for patients who fail medical management with compression stocking therapy and continue to be symptomatic from pain, achiness, or leg swelling. Stab phlebectomy is performed for larger bulging varicosities.

Published on Jul 11, 2012


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