I am a 45 yr old female and have had varicose veins since age 28. I have been unable to wear shorts or skirts or a bathing suit in public for the last 10 years due to how thick and visible my varicose veins are. I've always worn compression hose. Due to aching, my primary dr. referred me to a vascular surgeon. Ultrasound was "normal" he said. He said continue the stockings nothing else. He said EVLT or like procedures are a waste of money. How can that be??
EVLT Type Procedures Worth It for Varicose Veins?
Doctor Answers 12
Reasons to undergo EVLT procedures
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.
EVLA is only beneficial if you have reflux in the GSV or branch veins. If your ultrasound is normal, then you most likely would not benefit.
EVLT Is Not A Waste of Money
Ultrasound is frequently done to rule out a deep vein thrombosis. It is also performed in patients with varicose veins to determine how long it takes for valves to close. Patients with varicose veins have valves that take longer to close. When treating varicose veins, an ultrasound will determine if your valves are functioning properly. EVLT is a proven method of treating varicose veins caused by valvular insufficiency, and certainly not a waste of money and diagnostic for appropriate treatment.
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Get second opinion.
Varicose veins are almost always due to leaking(refluxing) valves of the saphenous system. However, they can also be due to refluxing valves of other veins such as the small saphenous vein, anterior accessory saphenous veins, pelvic or pudental veins, etc. The bottom line is that, if you do have varicose veins, then there has to be a cause and it is probably a refluxing valve somewhere. The physician needs to identify it with a complete venous reflux ultrasound. You should see a vein specialist who has experience in treating these problems.
Leg Varicose Vein Procedures, EVLT, Effectiveness
I disagree with the vascular surgeon who saw you and would recommend that you get a 2nd opinion (and a repeat ultrasound as well) by another vascular surgeon, but one that specializes in vein treatments. Based on the description you give, I think it is very likely that you have venous reflux disease and would benefit from treatment. The only way to know if you would truly benefit from an EVLT is by getting a good quality venous reflux ultrasound of the legs. Even if you are not a candidate for EVLT, there are plenty of other varicose vein treatments that you potentially could benefit from. In my experience, about 70% of patients with varicose veins are candidates for the EVLT procedure.
In terms of the EVLT procedure itself, it is very effective (over 95% effectiveness rate) and is the most common procedure used for treatment of varicose veins in the United States.
EVLT and Venefit Procedures Treat Venous Reflux Disease and Not Varicose Veins - Buffalo, NY
Endovenous treatment for reflux associated with varicose veins
since you have pain, varicose veins and have worn compression hose without improvement I would recommend a repeat duplex exam done elsewhere. The odds are you have venous reflux of the superficial saphenous system. I personally recommend and perform VNUS endovenous (RF) radiofrequency ablation of the affected saphenous veins since I feel it is safer and less traumatic than EVLT (laser). RF uses temperatures of 85 or 120 degrees celcius and EVLT (laser) uses temperatures of 700 degrees celcius and depends on the surgeons ability to 'pull back the catheter' at a given rate. RF does not require the treatment to depend upon 'rate of pull back'. I personally have had RF on one leg and it is the best thing I have ever done for myself. Reasearch has also shown that RF is 97% successful in multicenter trials and post operative bruising and pain is much less than EVLT. Hope this is helpful. You can find a local surgeon at www . VNUS . com
Symptomatic varicose veins can be treated in many ways
If some time has passed since your last evaluation, I would consider getting another duplex ultrasound evaluating the deep and superficial venous systems for venous reflux. Occasionally, reflux is not apparent or difficult to see on certain days. It sounds like you have symptomatic venous disease. If reflux is NOT found again then superficial foam sclerotherapy or microphlebectomy can also be good options for localized disease and pain relief.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.