Procedure Names:
EndoVenous Laser Treatment® (EVLT)
Radio Frequency Ablation (RFA)

Anticipated Results:
Endovenous ablation uses targeted laser or radio frequency energy to seal the vein shut and help you look and feel better fast. The procedure provides:

• Decreased probabilty to develop stasis ulcers
• A relief from leg heaviness
• An improvement in general health
• A sense of well-being
• Confidence to bare your legs in the summer
• Confidence and desire to wear shorts/dresses again
• Desire to renew sporting activities
• Renewed energy and vigor

Procedure Description:
The endovenous ablation procedure is a revolutionary, minimally invasive laser or radio frequency treatment for treating varicose veins with no scarring. The energy damages the vein walls, shrinking them and closing the faulty vein so that the blood cannot flow through it. This eliminates vein bulging at its source. After the treatment, the blood in the faulty veins will be diverted to the many normal veins in the leg.

Watch a video from the Diomed, the company that developed EVLT, to see the procedure in action.

Length:
45 minutes

Anesthesia:
Local anesthetic

In/Outpatient:
Outpatient procedure

Side Effects:
There is less than a 1 percent chance of developing deep vein thrombosis (DVT) from endovenous ablation. This can occur at the common femoral vein which is where the greater saphenous vein enters the deep venous system.

Numbness may also occur in a small number of cases and on rare occasions can be permanent. It is common to experience pain around the inside area of the knee, which can last up to seven days following the procedure.

Recovery:
The procedure leaves no scars, has minimal postoperative pain, a quick recovery period, and provides almost immediate relief from your symptoms.

Walking immediately after the procedure is encouraged.

Minor soreness and bruising can be treated with over-the-counter, non-steroidal anti-inflammatory pain relievers (NSAIDs) as needed (i.e. Motrin, ibuprofen, Aleve).

Duration of Results:
Published clinical studies show that endovenous ablation has a 98 percent initial success rate with excellent long-term results.

Risks:
There are no risks from the treatment, but when using the laser for EVLT, special glasses will be provided as a precaution against accidental firing of laser energy outside the body.

• Surgical treatment: Traditionally faulty saphenous veins have been treated with surgical ligation and stripping. This involves at least two surgical incisions in order to tie off and pull out the faulty vein and is usually performed under general anesthesia.
• Minimally invasive: Ultrasound-guided sclerotherapy (injection therapy) involves an irritant chemical that is injected into the vein followed by tight compression. This treatment is limited in the size of vein which can be treated and has a high recurrence rate frequently requiring re-treatment. However, it is excellent for cosmetic treatment of small veins and to treat any visible veins remaining after endovenous ablation.

Top Duke specialists:
Cynthia K. Shortell, MD
Jeffrey H. Lawson, MD, PhD
Shawn M. Gage, PA

FAQS

What are the long term consequences associated with varicose veins?
Eczema, pigmentation, ulceration, bleeding

Is loss of a vein a problem?
No. After treatment, the blood in the faulty veins will be diverted to the many normal veins in the leg.

What are the main benefits of endovenous ablation compared to other conservative management methods?
Endovenous ablation cures the problem rather than just slowing its progression. In addition, in many cases, no unpleasant compression stockings are needed after the first week.

What are the main benefits of endovenous ablation compared to surgical vein stripping?
Much less trauma to the leg and fewer side effects, no operative scars, no general anesthesia, no hospital stay, much quicker recovery with less post treatment discomfort

What are the main benefits of endovenous ablation compared to alternative minimally invasive treatments?
Minor skin discoloration that will be gone after four weeks, much reduced risk of major complications, reduced risk of minor complications