FAQ's about EVLT®   What does EVLT® stand for? EndoVenous Laser Treatment How does the procedure actually work? A laser fiber is fired inside and along the length of your faulty, varicose vein. The laser energy damages the vein walls, shrinking them closed so that blood can no longer flow through. Is loss of this vein a problem? No. There are many veins in the leg and after treatment the blood in the faulty veins will be diverted to normal veins with functional valves. The resulting increase in circulation will significantly relieve symptoms and improve appearance. Are varicose veins and spider veins painful or dangerous? Spider veins usually do not need medical treatment. But varicose veins usually enlarge and worsen over time. Severe varicose veins can cause health problems. These include: Severe venous insufficiency. This severe pooling of blood in the veins slows the return of blood to the heart. This condition can cause blood clots and severe infections. Blood clots can be very dangerous because they can move from leg veins and travel to the lungs. Blood clots in the lungs are life-threatening because they can block the heart and lungs from functioning. The earlier you receive treatment the better the long term clinical results. What should I expect from the EVLT® procedure? Your doctor uses ultrasound to map out your vein. Local anesthetic is applied. A thin laser fiber is inserted through a tiny entry point, usually near the knee. Laser energy is delivered to seal the faulty vein. Walking immediately after the procedure is encouraged. Normal daily activity can be resumed; just avoid rigorous activities such as gym workouts. There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary. What are the side-effects and complications of this procedure? EVLT®, like all minimally invasive procedures, can potentially have some slight bruising, which commonly disappears within the first few weeks. With EVLT®, you will feel a delayed tightness (or “pulling” sensation) 4-7 days after laser treatment which is normal and expected following a successful treatment. All surgical procedures involve some element of risk and have the potential for complications. This should be balanced against the risk of complications if your varicose veins remain untreated. Consult your physician for further information. Am I at risk from the laser? You will be given a pair of special glasses to wear to protect your eyes, however this is just a precaution against accidental firing of laser energy outside the body. What are the alternatives to this treatment? Surgery (called ‘Ligation & Stripping’) is the traditional treatment, but it can be quite painful and often has a long recovery time. It is performed in a hospital, involves general anesthesia, leaves a scar, and has a fairly high recurrence rate (on average 10-25%). Other alternatives include ultrasound-guided sclerotherapy (injection therapy) and radio frequency electrosurgery. Injection therapy for the saphenous vein has a high recurrence rate frequently requiring retreatment and is generally limited to smaller varicose and spider veins. Radiofrequency electrosurgery is more limited in the range of patients it can treat and the treatment time is longer than EVLT®. How successful is EVLT®? Clinical data with up to 5 years of follow-up show success rates of 93-98%. This is much higher than surgical ligation and stripping, radiofrequency electrosurgery, and injection sclerotherapy. Market researchers predict that, based on its superior efficacy and lower morbidity, endovenous laser treatment will soon become the new ‘gold standard’. How much does it cost? EVLT®, when medically necessary (e.g., for relief of symptoms), is commonly reimbursed by most carriers (including Medicare), limiting the cost to the patient. Contact your specific insurer for details. What happens when the Valves Fail? Valves in the vein lack the apposition needed to prevent reverse flow of blood down your leg Prolonged dilation damages the valves, so even when vasoconstriction occurs, the blood continues to flow in the wrong direction The resulting backpressure is termed “venous hypertension”, and this is what causes the painful varicosities.