Veins return blood back to your heart and have one-way valves that prevent the blood from flowing backwards due to gravity. If the valves do not close properly, the blood will pool in that area of the vein. This abnormal collection of blood will push the vein walls outward, causing the vein to enlarge and bulge, commonly called a varicose vein.
Endovenous Laser Treatment (EVLT) is a quick, minimally invasive laser procedure for patients who suffer with painful and unsightly varicose veins. This technique has shown a 98% success rate and offers major advantages compared with the alternative treatments.
Tens of millions of women and men suffer from varicose veins. Heredity is the most common cause, however women are almost twice as likely to have varicose veins. Other contributors to varicose veins include pregnancy, HRT (hormone replacement therapy) and birth control pills, obesity or sedentary lifestyles, aging, and professions that require prolonged standing or sitting.
While unsightly varicose veins create a cosmetic concern for patients, they also can cause legs to ache or swell. Legs may feel tired, heavy, or may develop a burning sensation as the day goes on. In more severe cases, varicose veins may cause the skin to change, resulting in eczema, ulceration or bleeding, and/or pigmentation changes.
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Charlotte Radiology's Interventional Radiologists will help you determine if you will benefit from EVLT. During an initial consultation, our physician carefully examines your medical history and veins, maps out problem areas, and may even recommend an ultrasound to rule out any deeper issues. If it is determined that you are a candidate for the procedure, a more detailed ultrasound will be scheduled prior to performing the procedure.
The saphenous vein and other veins that may be considered usable for future surgical bypass procedures may not be considered for injection. If you are pregnant or breastfeeding, you may be advised to wait 3-4 months after pregnancy, as many veins that appear during pregnancy will disappear on their own in time. It also is not known how the sclerosing solutions interact with breast milk; so it may be best to wait until after you are done nursing your newborn to consider sclerotherapy.
Purchase your prescription strength compression stockings prior to your EVLT procedure appointment; get your prescription filled a week prior, unless otherwise instructed by your physician. This will allow for extra time in case your size is not in stock and needs to be ordered. If you already have compression stockings, bring them with you to one of your appointments so that we can verify that they are of a high enough strength. If you arrive for your procedure with stockings that we did not prescribe or approve ahead of time, you may have to reschedule your appointment. Be sure to make arrangements to have a driver, as you will not be allowed to drive yourself home after the procedure. Your driver must come into the office with you when you check in. Once we begin the procedure, he or she may leave and return for you later. Your driver can return to pick you up in about two hours. Shower and wash your legs thoroughly the day of your procedure. DO NOT apply lotion, cream or powder to your legs. Bring loose fitting pants to wear home after the procedure.
EVLT is a procedure that takes about 45 minutes. However, the entire appointment will last around 2 hours. EVLT uses laser energy delivered in a thin fiber-optic probe to treat the underlying cause of the varicose veins. Performed under ultrasound guidance, the procedure uses strictly local anesthetic.
Prior to the procedure you will be given a mild sedative, Xanax or Valium, to help you relax but not put you to sleep. You will be awake and comfortable for the procedure. We will mark your vein using ultrasound and prep you for the procedure. During the procedure, the area of the leg affected is locally anesthetized or numbed using Lidocaine, and a small catheter is inserted. You will then be injected with a diluted solution of Lidocaine along the vein from the injection site to the groin area. Next a thin laser is inserted into the catheter and pulled down the saphenous vein to the injection site; this may take 1-3 minutes depending on the length of the vein. Your body will naturally use other healthy veins to return blood to the heart. The laser is then withdrawn from the body and a small dressing will be placed on your insertion site. We will put the compression hose on you and then you may get dressed. You will be asked to walk on a treadmill for 15 minutes.
Early results have been extremely favorable with success rates as high as 98%, without the complications of surgery. EVLT will normally treat the cause of most varicose veins, however, in some cases, patients may require additional therapies or procedures to complete the treatment plan. Often this additional treatment is sclerotherapy, which is also available at the Charlotte Radiology Vein and Vascular Center.
Directly following your procedure you must NOT take off the compression stockings and dressing for the first 24 hours; this is to help healing and decrease swelling. After 24 hours, you may remove the stockings and dressing to bathe and sleep; however you must wear the stockings at all other times for the next two weeks. You may resume normal activities after your procedure, but may not perform any strenuous activities or heavy lifting for two weeks or fly in any aircraft. If you experience pain or discomfort, you may take Tylenol or Ibuprofen. Soreness may disappear after 24 hours. Mild sorness may last 7-10 days. About 5-8 days after the procedure you may feel tightness or pulling along the treated vein; this is normal and will typically go away in 2-3 days.
To evaluate the success of your procedure, you will be scheduled for an ultrasound two weeks after your procedure.