Doctor Opinions About EVLT and VNUS Closure

I have used both Laser and RF for venous insufficiency and both work well.  The data are pretty equal in closure rates.   I personally prefer laser.  In my hands, I have seen better results in closure rates, short and long term.  It is best to find someone who has significant vascular experience with veins.  Good luck!

Both of these treatment options are great for treating and closing the Great Saphenous Vein (the vein that most often is responsible for varicose vein disease).  In general, they both work very well and have excellent (95%) long-term success rates.  The RFA procedure tends to lead to less pain and bruising for the first 3-4 days after the procedure.  Beyond the first 4 days, patients seem to have very minimal pain with both procedures. 

With the higher wavelengths for EVLT, especially the 1470nm laser there is no significant difference in procedure success rates, complications and post-op pain compared with VNUS.  I have tried both but now use exclusively laser as a matter of personal preference and because it allows for the treatment of a wider range in vein size. I have always gotten consistently good results with the EVLT 1470nm laser.

Even
though both are minimally invasive procedures, radio frequency ablation (RFA)
has been associated with less pain, bruising, and complications. Patients may
also go back to normal more quickly with RFA than with vein stripping or laser
ablation. Walking regimen, compression stocking, and avoiding strenuous
exercise and heavy lifting is recommended after the RFA procedures. Also, RFA
is covered by insurance. 
Best, 

When performed correctly , both VNUS Closure and EVLT yield comparable results. Early on there were some differences, but in current day practice, they are the same 

Although they both have been around for similar times the RF got more attention at the beginning for several reason.  The original lasers used were different wavelengths and caused more pt discomfort and more downtime.  This along with bigger reimbursements to use RF were the big driving forces for physicians to use RF. With advanced technology and improved wavelengths i.e. the 1470 wavelength targeting water in the blood and reduction in reimbursement on RF the EVLT technique has gained significant volume.  I use EVLT and have always gotten a consistent and wonderful result.  

EVLT And VNUS have been around since late 90s early 2000s.  They have gone through multiple generations. I would say that in the beginning I liked Laser better but now the procedures are about equal in risk, benefit, success and complication rates. The  newer lasers using higher wavelengths like the 1470 which we use selectively treats water and heats the blood and limits damage to surrounding tissues and muscle.  The newer RF catheters as well are very selective, can be used on various size veins and have minimal bruising or damage to the surrounding tissue.  There are newer procedures like vein glue =venaseal and others.  I was one of the first in the country to perform clarivein and we almost never use this any more due to pain and other complications following the procedure.  Find out what your physciain is most comfortable with 

Both EVLT(laser) and VNUS(radio frequency) work and their results are similar.  Which one a particular doctor uses depends usually on their personal preference, background and experience.  I have used both and I own both but I never use the VNUS system any more.  With the newer higher wavelength lasers(1470) there is minimum post procedure bruising, discomfort or downtime.  Technically I feel the laser is easier to use and capable of assessing smaller veins and, in my hands, the superior product to use.

Both VNUS Closure and EVLT tNever Touch treat venous reflux dissease, also known as venous insufficiency. For example, once access is gained into the great saphenous vein, a radiofrequency catheter (VNUS) or laser catheter (EVLT) can be used to obliterate the great saphenous vein. This treats venous reflux disease originating at the saphenofemoral junction or saphenopopliteal junction.
Unfortunately, most phlebologists have the VNUS Closure machine or EVLT machine. Very rarely do they have all three technologies (VNUS, EVLT and ClariVein, since the machines are expensive and they accomplish the same goal. We have EVLT Never Tuch, ClariVein aand VNUS Closure in our practice and used them selectively depending on the size of the vein and how close it is to the skin. As well, given my background in heart surgery, I utilize EVLT because theoretically it is unlikely to interfere with pacemaker/defibrillator function in individuals who have these devices in place.ClariVein uses mechanochemical ablation. The vein Treatment Center has a Director who is an MD and a Fellow of the American College of Surgeons and who has added board certification from the American Board of Surgery, American Board of Thoracic Surgery (cardiovascular surgey) and who is certified by the American Board of Venous and Lymphatic Medicine (ABVLM). Dr Karamanoukian is also a registered physician in vascular interpretation (RPVI). The Vein Treatment Center performs VNUS Closure, EVLT laser ablation, ClariVein, foam sclerotherapy among other ablation technologies. We are currently (February 2015) evaluating Sapheon and Varithena - glue and chemical ablation.

The source of energy to close vein has change over time, research shown EVLT 1470 nm and RF almost have same results.
One important factor is enough amount of tumescent solution to numb the area  so decrease discomfort at the time of procedure, and close the vein and milk out the blood out of the vein is treated to decease and eliminate chance of blood clot, and also place enough solution to separate the vein from skin and the nerves around it to decrease or eliminate chance of numbness and skin burn. Another technique I use is that I cool the solution for better result and patient comfort.