Non-Surgical Treatments

ENDOVENOUS LASER PROCEDURE (EVLA)

 

ARE YOU A CANDIDATE?

Patients undergo a comprehensive ultrasound to determine if they are a candidate for endovenous laser ablation. The endovenous laser procedure is indicated for those patients who suffer with varicose veins or venous ulcerations caused by venous insufficiency (faulty valves). It is a minimally invasive procedure that is incredibly effective. The endovenous laser treats the underlying source of varicose veins and venous ulcerations.

This procedure uses light waves to eliminate even the largest of varicose veins. Endovenous medical lasers use light energy to destroy the inside of the vein walls. This causes veins to collapse, shut down and gradually disappear over several weeks or months.

Previously only surgical stripping and ligation was used to treat varicose veins.

There are several different endovenous lasers on the market today. Dr Smith uses the CoolTouch laser. Research indicates the CoolTouch laser as the best technology available for both safe and effective treatment.

The CoolTouch laser has a 1320 nm wavelength which has been found to be a comfortable, safe and effective laser treatment for varicose veins. In most cases only a single treatment is required.

EVLA involves a needle ( similar to a blood test) being inserted into the varicose vein to be treated. A very fine guide wire is precisely positioned within the target vein using ultrasound guidance. Anaesthesia is then placed around the vein using ultrasound guidance. The tumescent anesthesia has several functions, it prevents the heat of the laser causing pain, and the tunnel of fluid around the vein prevents the heat from the laser affecting the overlying skin or surrounding tissues. The guidewire is then removed and the laser fibre is inserted and positioned according to precise guidelines. The laser is fired and has an automatic pullback speed of 1 mm/sec. A typical laser run takes about 10 minutes. There is usually no sensation while the laser is firing, although some patients report a smoky taste or smell. which is entirely normal.

Once the vein is closed, the blood that was circulating through the vein is simply re-routed to other healthy veins and the varicose veins gradually disappear. The CoolTouch procedure is minimally invasive and is performed in a day theatre. You are awake during the entire procedure. You will be monitored throughout the procedure for blood pressure, and pulse oximetry.We find patients find the procedure very manageable with minimal discomfort.

ARE THERE ANY POTENTIAL COMPLICATIONS?

Complications are very rare. Some temporary skin numbness above the course of the vein treated with the laser is a common occurrence. This typically totally resolves with time. A “pulling” sensation along the course of the vein treated with the laser is also common. The sensation is usually felt 1 week after the procedure. The “pulling” sensation is due to the healing process and typically resolves in 2-3 weeks. Follow-up ultrasounds are done at 2 weeks and 3 months to ensure the vein treated with the laser remains closed. The chance of varicose vein recurrence following the combination of endovenous laser ablation and sclerotherapy injections is less that 1%.

An extremely rare complication is the formation of a deep venous clot .07-1%. This is almost completely prevented by walking, resumption of normal activities and compliance with wearing the compression hose as directed.

 

Most patients with varicose veins also have spider veins which are small unsightly veins located just beneath the skin. These are most effectively cleared using sclerotherapy, which involves the injection of a substance that destroys the spider veins. We have been able to achieve fantastic results by performing endovenous laser ablation, ultrasound guided sclerotherapy at one sitting. The final results have been truly life changing for our patients.

Problematic leg veins cause physical symptoms but they may also cause emotional distress as well. Whether it’s avoiding wearing shorts and skirts or a beach trip, a person’s quality of life may be severely affected. At Vital Face and Vein Dr Smith specialises in the treatment of problematic leg veins using the most advanced techniques and technologies available. There is simply no reason to suffer the pain and embarrassment of problematic leg veins any longer.

ULTRASOUND GUIDED SCLEROTHERAPY

 

ULTRASOUND GUIDED SCLEROTHERAPY (UGS) IS A SPECIALISED PROCEDURE FOR TREATING VARICOSE VEINS THAT ARE HIDDEN BENEATH THE SKIN.

The procedure is extremely safe and effective, involving injecting a sclerosant solution into the abnormal veins using ultrasound guidance, causing the vein wall to collapse. The veins dissolve and disappear as the body gradually absorbs them.

As with microsclerotherapy, once the sclerosant solution is injected, it is extremely safe and effective.
AFTER TREATMENT

The treatment usually takes half an hour per leg. Following the procedure, patients are fitted with grade 2 graduated compression stockings and asked to go for a 60 minute walk to promote blood flow in the deeper veins. Patients are normally reviewed two weeks following the UGS procedure. At this review appointment, another detailed ultrasound is performed to ensure that the treatment was successful and any residual spider or varicose veins may be injected using the visual sclerotherapy technique.

THE ULTRASOUND GUIDED PROCEDURE

A detailed ultrasound scan of your veins is carried out prior to the procedure to create a vein map of the lower leg veins. This map precisely displays all abnormal or varicose veins. With ultrasound guidance, the doctor can accurately target the hidden varicose veins, observing the process on the ultrasound screen. Once injected, the treated vessel will collapse and gradually be absorbed by the body, disappearing with time. The use of sclerosant as foam, rather than solution, has made this procedure much more effective and allows the doctor to use lower doses of sclerosant.

AFTER TREATMENT

The treatment usually takes half an hour per leg. Following the procedure, patients are fitted with grade 2 graduated compression stockings and asked to go for a 60 minute walk to promote blood flow in the deeper veins. Patients are normally reviewed two weeks following the UGS procedure. At this review appointment, another detailed ultrasound is performed to ensure that the treatment was successful and any residual spider or varicose veins may be injected using the visual sclerotherapy technique.

WHAT DOES VEIN TREATMENT COST AT VITAL FACE AND VEIN WELLINGTON?

Price depends on the treatment required. An initial vein assessment costs $150.

Vein treatment is from $450 for micro-sclerotherapy to from $3000 for ultrasound guided treatment for larger varicose veins.

​Endovenous laser treatment is from $5000.

SIDE EFFECTS OF ULTRASOUND GUIDED SCLEROTHERAPY

Following treatment it is common to experience some minor symptoms that are considered a normal part of the healing process

  • Mild discomfort. Patients may develop discomfort in the areas that have been treated. This may occur on the first day or may occur days or weeks later. It represents the dissolving process occurring in the treated veins. Symptoms are improved by walking or by taking Paracetamol or Ibuprofen. Soreness behind the knee can result from rubbing by the stocking. Soreness in the heel of the foot is common and the cause is not clear.
  • Bruising. Bruising usually disappears within 2-3 weeks and is not a cause for concern
  • Tender lumps. These are common in the treated veins and persist for the first few months. The lumps represent “hardened” or “sclerosed” veins. They will gradually reduce in size and eventually disappear. .
  • Pigmentation. Iron deposits from “Trapped Blood” blood can be deposited in the skin along the treated veins. This is more frequent with large surface veins but can occur with spider veins. Most disappear within 12 months but less than 5% can persist beyond 12 months.
  • Matting. This consists of networks of fine dilated capillaries near the injection sites. It appears shortly after treatment in a very small percentage of patients. Most resolve spontaneously. If there is persistent matting, there may be a vein that has not closed during the treatment, and a repeat ultrasound may be performed to clarify this.
  • Phlebitis. Inflammation of the treated veins can occur during the healing process. It will appear as redness and tenderness over the “hardened veins”. but it is not serious and can be treated with oral Ibuprofen (Nurofen) and wearing the Class 2 Compression Stockings.

More serious complications such as ulcers, allergic reactions and deep vein clots are very rare.

Clotting risk is between 0.07% and 1%,the risk is minimised by following the clinics instruction carefully.