ENDOVENOUS LASER THERAPY AT ADVANCED VASCULAR

Do you suffer from painful legs?

Do your legs feel sore and heavy if you have been on your feet all day?

Do you have bulging or rope-like veins?

Have you wanted treatment of your varicose veins, but were not anxious to have a surgical stripping?

Now you may be a candidate for a new minimally invasive treatment called endovenous laser therapy (EVLT).

EVLT is a quick, minimally invasive procedure that leaves no scar, has a short recovery period, and is performed under local anesthesia in the doctor’s treatment room.

The treatment takes approximately one hour.  The affected leg is draped under sterile conditions and local anesthesia is given.  A tiny laser fiber is inserted into the abnormal vein and laser energy is delivered, closing the vein.

At the end of the procedure, the laser fiber is removed and compression stockings are applied and worn for seven days. Patients are told to walk immediately after the procedure for 10 minutes, and normal daily activities can be continued. Aerobic exercise and hot baths, however, should be avoided for 10 days.

Discomfort during the procedure is minimal.  Bruising and soreness may last for 7-10 days after the EVLT, which is generally relieved by Tylenol.

Normal vein compared with a varicose vein containing "incompetent" valves.

Veins throughout your body return blood you your heart. To do this efficiently, veins have one way valves to prevent blood from flowing backwards due to gravity. If the valves fail to close properly, blood will pool in the vein. Over time, this pooling will force the vein walls outward, resulting in enlargement and sometimes bulging of the vein giving it a rope-like appearance..

You are not alone…Millions of people around the world suffer from varicose veins, with hereditary factors playing an important role in their development.  Women are nearly twice as likely as men to be affected with varicose veins.

Pregnancy, hormone replacement, professions with prolonged sitting or standing, increasing age and obesity

ADVANCED VASCULAR, a division of Advanced Radiology P.C. specializes in diseases affecting arteries and veins throughout the body. It is headed by Joel E. Perchik, MD a board certified radiologist with Fellowship training in Vascular Interventional Radiology from Vanderbilt University and a Certificate of Added Qualification (CAQ) in interventional radiology. He has received additional training in the treatment of varicose veins from Rob Min MD, who pioneered EndoVenous Laser Treatment., at New York Presbyterian Hospital. Dr. Perchik is the first physician to bring this technology to the state of Tennessee.

FAQ

How does the EVLT actually work?

The laser energy damages the vein walls, causing them to collapse and shrink so that blood can no longer flow through the faulty vein.

Is losing the vein a problem?

No. The vein is usually doing more harm than good. It is not a problem to remove these veins as the deep venous system will take over the blood flow of these veins.

What are the potential complications of the procedure?

No serious complications have been reported in well over 1500 cases through July 2002.  A small number of people have had transient paresthesia (numbness).

What are the symptoms?

Varicose veins may sometimes only be a cosmetic problem, but they can be a cause of leg pain and swelling, which is usually most severe at the end of the day or after prolonged standing. Leg heaviness, burning sensations, and night time leg cramps are also associated with varicose veins in severe cases and can also lead to skin changes and ulceration.

FAQ

Am I at risk from the laser?

No.  You will be given a special pair of glasses to protect your eyes in case of accidental firing of laser outside the body.

What is the alternative treatment?

The traditional treatment has been surgical ligation and stripping of the saphenous vein.  This involves at least two surgical incisions to pull out the faulty vein.  EVLT has a lower risk, shorter recovery period, lower cost, and no scarring compared to surgery.

Are there alternative minimally invasive treatments?

Yes.  The two common ones are ultrasound guided sclerotherapy and radiofrequency(RF) ablation.  Sclerotherapy is excellent for veins remaining after EVLT. RF ablation is more limited in the size of veins it can treat.

How successful is EVLT?

Early results have been excellent with success rates as high as the conventional surgical approach.  EVLT will treat the cause of most varicose veins, but additional therapy may be necessary.

REFERENCE:

Min RJ, Zimmet SE, Isaacs MN, Forrestal MD.: Endovenous laser treatment of the incompetent greater saphenous vein.
J Vasc Interv Radiol. 2001 Oct;12(10):1167-71.