Endovenous Laser Treatment (EVLT)
Laser Treatment of Varicose Veins
Endovenous ablation shuts down a large, long vein by targeting heat energy inside the vein to seal it shut.
Laser catheter uses heat energy in great saphenous vein to seal vein closed.
This heat can be created with a laser, known as endovenous laser ablation (EVLA), or with radio frequency ablation (RFA). Both are the latest technologies and replace vein stripping procedures that had been used.
EVLA and RFA are minimally invasive and highly effective. They are usually performed in a comfortable office setting. EVLA is also sometimes referred to as EVLT® (endovenous laser treatment).
For various reasons, only one large vein can be treated with laser ablation at a time. If you have more than one abnormal veins eligible for laser treatment, they can each be treated approximately two to three weeks apart.
Other advantages of EVLA and RFA include:
- Treatment in less than an hour
- Can be performed in the doctor's office
- Up to 98 percent success rate
- Immediate relief of symptoms
- Return to normal activities immediately
- No general anesthesia or hospitalization
- No scars
Here's what to expect from the procedure:
- Your doctor uses ultrasound to map out the vein to be treated.
- Local anesthesia is applied.
- A thin catheter is inserted through a tiny entry point, usually near the knee.
- Laser or radio frequency energy is delivered to seal the vein shut.
- After the catheter is removed, a small bandage is placed over the insertion site.
- Your compression stocking will then be placed on your treated leg; you should wear it for one week following the procedure.
- Walking around the clinic for 20 minutes 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.
- One week after the procedure, you will be given an appointment for an ultrasound of the treated vein to ensure is still closed.
- RFA and EVLA treat the large vein or veins that caused your varicose veins in the first place. They do not directly shut down those visible varicose veins themselves, although these may shrink in size and number after RFA/EVLA.
- In some cases, treatment with RFA or EVLA is all that is needed to eliminate all the visible varicose veins. However, for most patients, a second procedure, usually sclerotherapy is needed to treat the remaining veins.
After the vein is closed, healthy veins take over and reestablish a healthier blood flow. Possible complications are similar to those of other venous procedures: numbness, bruising and phlebitis (inflammation of the vein).
The VNUS Closure procedure is a minimally invasive treatment alternative with less pain and less bruising when compared to traditional vein stripping surgery and laser treatment. Using the Closure system, physicians close the diseased veins by inserting the Closure catheter into a vein and heating the vein wall using temperature-controlled RF energy. Heating the vein wall causes collagen in the wall to shrink and the vein to close. After the vein is sealed shut, blood then naturally reroutes to healthy veins.
Venous reflux or venous insufficiency develops when the valves that usually keep blood flowing out of your legs become damaged or diseased.
The Closure procedure provides the following benefits for patients and physicians:
- Minimally Invasive Outpatient Procedure. Closure catheters are inserted into the vein via a tiny incision in the lower leg, eliminating the need for groin surgery and general anesthesia. The Closure procedure can be performed using local anesthesia in a physician's office, as well as in an outpatient hospital setting or surgicenter.
- Clinically Proven Less Post-Operative Pain. The Closure procedure does not involve pulling the diseased vein from the thigh as with vein stripping surgery, or using 700° C laser energy which boils blood to occlude a vein as with endovenous laser (EVL)12. In the RECOVERY Trial, a multi-center head-to-head comparative randomized trial comparing the Closure procedure with EVL, the Closure procedure was found to have less patient pain and less patient bruising than EVL for the best patient recovery experience available from a minimally invasive vein treatment.10 Additionally, in other randomized comparative studies have shown that patients receiving the Closure procedure return to normal activity and work significantly faster than those receiving vein stripping.3
- Excellent Clinical Outcomes. The ClosureFAST catheter, which represents the latest advancement in the Closure procedure, has been shown in a multi-center study to have a 97.4 efficacy rate at one-year.11 This shows that the treatment is highly effective and, as proven in the RECOVERY trial, is gentle on the patient.10
- Cosmetically Appealing. Because treatment with Closure is minimally invasive and is catheter-based, it results in little to no scarring. As with any medical procedure, you are encouraged to review all safety information associated with the procedure by consulting your physician.
2. Data on File - VNUS Medical Technologies, Inc.
3. Lurie, F, et al.Prospective randomized study of endovenous radiofrequency obliteration (Closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study), J Vasc Surg 2003; 38(2):207-14.
4. Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: A multicenter study. J Vasc Surg 2002;35:1190-6
5. Weiss RA, et al. Controlled Radiofrequency Endovenous Occlusion Using a Unique Radiofrequency Catheter Under Duplex Guidance to Eliminate Saphenous Varicose Vein Reflux: A 2-Year Follow-up, Dermatologic Surgery, Jan 2002; 28:1: 38-42
6. Jones L, et al. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomized trial of stripping the long saphenous vein, Eur J Vasc Endovasc Surg, 1996; 12: 442-445
7. Morrison N. Presented at the Union Internationale de Phlebologie, Rome, September 2001.
8. Pichot O, et al. Role of Duplex Imaging in Endovenous Obliteration for Primary Venous Insufficiency. J. Endovasc Ther 2000; 7:451-9.
9. Proebstle TM, et al. Endovenous Treatment of the Greater Saphenous Vein with a 940 nm Diode Laser: Thrombotic Occlusion after Endoluminal Thermal Damage by Laser Generated Steam Bubbles, J Vasc Surg 2002; 35: 729-736.
10. RECOVERY Trial – Data on File – VNUS Medical Technologies, Inc.
11. Dietzek A, Two-Year Follow-Up Data From A Prospective, Multicenter Study Of The Efficacy Of The ClosureFAST Catheter, 35th Annual Veith Symposium. November 19, 2008. New York.
12. Weiss RA, et al. Comparis on of Endovenous Radiofrequency Versus 10nm Diode Laser Occlusion of Large Veins in an Animal Model. Dermotol Surgery 2002; 28: 56-61