EVLT Type Procedures Worth It for Varicose Veins?

Based on the description of your veins and your evaluation, I recommend you get a second opinion and make sure you see a Vein Specialist (not all Vascular Surgeons are Vein Specialist and not all Vein Specialist are Vascular Surgeons). Ultrasounds have limitations in that they are going to be to a large extent technician dependent. It is important that a good technician with adequate experience perform the ultrasound. In addition, a good ultrasound MUST include evaluation in the standing position; if this was not done, and is not that uncommon, then they could have easily missed reflux. Other factors like dehydration or excessive cold in the exam room may also lead to missed reflux. In addition, some places simply do not take adequate time. A detailed ultrasound will usually take 30 to 60 minutes to perform. Now, if there is in fact no reflux requiring EVLT and this is less likely. There are still other procedures like ambulatory phlebectomy that could be beneficial.  Hope this helps, best of luck.

If you truly have varicose veins, that is not normal and there should be some abnormality found on ultrasound.  Based on the described appearance of your legs and your symptoms ( aching legs) it would probably be worth seeking  a second opinion. Depending upon what the ultrasound shows , EVLT may not be an appropriate treatment option for your problem  but there would be alternatives such as phlebectomy or sclerotherapy .  

if you have varicose veins, they can be treated. Ask your vascular surgeon what Toby suggest to make your legs feel better. If they don’t ha e an answer go somewhere else and find someone who can address the veins that bother you. 

EndoVenous Laser Treatment (EVLT) has many advantages over the "old" vein stripping techniques of the past.   If you have thick, varicose veins, it is unlikely an isolated issue.   I would obtain another vascular ultrasound to see if there are other perforator or accessory veins feeding your large varicose veins.   If the ultrasound is still negative for greater or lesser saphenous vein reflux, consider microphlebectomy and sclerotherapy to treat your veins.  EVLT has a very high patient satisfaction rate and can often be covered by insurance if there are medical indications.   

EVLT is specifically indicated for the endovenous ablation of the greater saphenous vein in cases of venous reflux.  If your ultrasound is normal, chances are you would not benefit from EVLT.