Endovenous Laser Treatment, (EVLT) is the latest, FDA approved, state-of-the-art minimally invasive treatment for large, unsightly bulging varicose veins which have traditionally been treated by an invasive procedure called surgical stripping. Surgical stripping is done in the hospital under general or spinal anesthesia. It requires considerable time off work, and multiple small surgical incisions that leave scars on the legs. However, Endovenous Laser Treatment is done in our office under local anesthesia, and requires little to no recovery time. In fact, most patients can come during their lunch break, get the procedure done in about 45 minutes, and return to work the same day!

Endovenous Laser Treatment is used to treat diseased varicose veins, and is therefore covered by most major insurance carriers, and Medicare.

What are Varicose Veins?

Varicose Veins are large, bulging veins caused by backflow of blood in the veins. Normally, the blood flows in the veins from the foot, upwards towards the lungs and heart. This flow is controlled by valves that allow blood to flow only in one direction, which is upwards. Certain factors, such as heredity, family history, or other reasons cause these valves to become damaged, which causes bi-directional flow of the blood. This causes the veins to dilate from increased pressure, and turn into the varicose veins that you can see.

What is the traditional treatment for varicose veins?

The traditional treatment is called surgical stripping of the veins. In this complicated procedure, usually done under general or spinal anesthesia in a hospital setting, the veins are stripped out of the leg through numerous small incisions made along the course of the vein(s). These cuts usually heal with the formation of a small scar. The procedure is invasive, required several days off work, and is approximately 5-7 times more expensive than endovenous laser treatment offered in our office.

What is Endovenous Laser, and how does it work?

The Endovenous Laser Treatment is a revolutionary new treatment that is FDA approved, minimally invasive, and performed under local anesthetic right in our office. With the endovenous laser, a thin optic fiber is introduced through a needle into the varicose vein via ultrasound guidance. The laser energy is then activated, and the laser fiber is slowly withdrawn from the vein. This procedure will generate enough heat to close the vein. With the closure of the main varicose veins, the smaller, surrounding veins may shrink or disappear. However, in some cases, additional treatments like sclerotherapy or ambulatory phlebectomy may be needed. This vein is ultimately then converted into scar tissue and absorbed by the body. Once the diseased vein is closed, the blood is re-routed naturally through healthy veins.

Choosing the right treatment provider and technology.

The endovenous laser treatment has only been on the horizon for the last few years, and is gaining popularity. It is expected that over the next 4-5 years, surgical stripping will become obsolete. Most physicians are still trained the old-fashioned way, which includes surgical stripping. It is important that you at least consider or ask your physician if endovenous laser is right for you. Among the endovenous laser technologies currently on the market, we find that 1320 NM CoolTouch technology is the best. This technology targets the water in the endothelium of the veins, thereby causing no damage to the surrounding tissues around the vein(s). Other lasers rely on your vein being filled with blood. This blood is targeted by the laser, and the risk of complications such as pain along the vein and blood clots is higher.

What is Ambulatory Phlebectomy?

After endovenous laser treatment for the main veins of the leg, it is usually expected that the smaller, surrounding veins either disappear or shrink. If they do not disappear, they can be treated by either sclerotherapy, or a procedure called ambulatory phlebectomy. Ambulatory Phlebectomy is a simple procedure done under local anesthetic where small segments of the veins are removed through small needle holes.

Is this procedure covered by insurance companies?

Yes. Since varicose veins are a disease, most insurance carriers and Medicare will cover this procedure. However, if you do not have insurance, we provide short and long-term interest-free financing.

What happens if I leave my varicose veins untreated?

If left untreated, varicose veins can cause a host of problems like pain, swelling, discoloration, and severe itching. It can also cause restless leg syndrome, skin breakdown, and ulcer formation that will be difficult to heal. In our practice, we recently treated a patient who had a non-healing leg ulcer for over 2 years. This patient did not respond to traditional treatments for uclers, but responded beautifully after the underlying problem of varicose veins was addressed. Look at the before and after:

Before	After

	After