Normally, the healthy arteries in our body carry blood away from the heart and healthy veins carry the blood back to the heart. Upward blood flow from the lower extremities is helped along by valves that are located at various points in the legs. These valves prevent blood from accumulating in the vein. Sometimes, failure occurs and blood does pool where it shouldn’t. This causes the vein to enlarge and weaken. Because this initial valve failure puts stress on the remaining valves in the vein, reflux worsens over time.
To resolve the problem, the diseased vein must be closed and the blood re-routed to healthy veins. Historically, venous insufficiency was treated with major vein stripping surgery. Fortunately, vein specialists have developed innovative new protocols based on modern technology. Endovenous laser ablation surgery, ELAS, is one of them.
ELAS, also known as Endovenous Laser Treatment (EVLT) is a minimally invasive vein treatment that is performed under local anesthesia in an outpatient setting. This surgery is a modern method of treating diseased varicose veins. A normal vein is able to carry blood because it contains valves. The valves direct blood towards the heart and stop the blood from returning to the foot. Once the valves fail, the vein becomes enlarged.
As the vein enlarges, additional valves fail, increasing reflux. To resolve the problem, ELAS allows us to close the problem vein and reroute the blood to healthy veins. This procedure approaches the vein with ultrasound guidance and the intent of closure, not full removal. As such, it requires only a tiny incision.
Endovenous laser ablation surgery, sometimes called endovenous laser therapy, typically takes 45 minutes or less to complete. Because no sedative anesthesia is necessary for treatment, patients are able to drive themselves to and from their visit.
The procedure will begin with our providers identifying and mapping out the diseased vein with ultrasonography while standing. We then have our patients lie on the examination table as our team introduces a laser fiber into the vein. We ensure the correct position of the fiber by imaging the vein and the fiber. Local anesthesia is then injected around and along the vein to be treated. The laser fiber is activated. As the fiber slowly withdraws, the heat of the fiber closes the vein. The leg is wrapped afterwards. Over time, the vein transforms into a scar. Following the procedure we encourage our patients to walk. The day after surgery the patient will have an examination to ensure a satisfactory recovery.
There are several reasons why patients select endovenous laser ablation surgery. These include:
Our priority in treating venous reflux is to achieve the best possible results. We perform a comprehensive exam and consultation to determine the potential for ELAS as an appropriate vein treatment for patients in good general health. In some cases, veins may be too small or twisty to respond well to this approach.
Over time, the vein transforms into a scar and its visibility decreases. The long-term success of endovenous laser ablation surgery is higher than 95%, making this safe and effective procedure a valuable treatment option for many of our patients.
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Immediately after vein treatment, we wrap the leg with gentle pressure. Walking should resume right away to encourage blood to divert from the closed vein. The day following your treatment, we will exam your veins. A compression garment may be necessary for the first week following treatment, after our team removes the initial wrapping. During recovery, you may take a mild over-the-counter pain reliever to manage comfort if necessary. Patients can expect a full return to normal activities in approximately 7 to 10 days.
The risk for complications is very low, but do exist. We are careful to minimize the risks for prolonged tenderness, redness, and bruising along the vein. Infection at the point of entry into the vein may also occur. Other rare complications include the development of deep blood clots and lingering sensations of burning or numbness.
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