VNUS closure got to market about two years before the first vein laser. Some insurance companies approve both technologies, some only VNUS (as of now). The VNUS device is more complicated and considerably more expensive to use. Both technologies are FDA approved. I have found that the laser is almost 100% successful in closing average-sized saphenous veins, and it is definitely more effective than the VNUS device for closing large saphenous veins.

These are 2 of the newer, less-invasive surgical procedures performed on the large varicose veins only. Although some doctors still perform VNUS Closure, most experienced vein specialists are gradually doing less of this and more of EVLR. These procedures are designed to be performed on the main veins, especially the Greater Saphenous Vein (GSB).

Theoretically anyone can get a DVT after any surgical procedure. However, the risk of DVT after EVLT is very low (less than 1 in 400).

No. Generally the saphenous vein is only destroyed when it is thick and thrombosed. The vein in this state is almost useless and non- functioning and there is no harm in removing it. However, a normally functioning saphenous vein with no leaky valves should not be treated. A normal saphenous vein should always be preserved because it may be required in the future for open heart surgery.

In theory, blood flow can resume. However, the probability of the saphenous vein reopening appears to be no more than 10% out to 2 years. One published report found that at 2 years 90% of Closure treated veins were invisible to ultrasound, suggesting permanent obliteration.

EVLT is a minimally invasive way of treating varicose veins. Instead of making a cut in the groin and stripping the vein from the thigh, the surgeon uses a fine laser fibre to zap the vein from the inside.

High ligation is another surgical procedure done in the operation room under local or general anesthesia. It involves a groin incision (possibly on both sides). The tissue is dissected by the surgeon down to the greater saphenous vein (GSV)/femoral vein junction. The greater saphenous vein is then clamped and tied off. The idea is to sever the connection between the superficial system (the GSV) and the deep system (the femoral vein).

ELAS, or endovenous laser therapy, involves placing a thin laser filament into the vein through a needle puncture in the lower leg. Laser energy is used to heat the vein from inside, causing it to close down. Closure by laser has a 98% rate of completely closing down the vein. Each patient will be evaluated by our surgeon to determine which treatment is best for them. Yes. Using a laser to close the vein is a painless, minimally invasive alternative to vein stripping.

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It is true that many times the greater saphenous vein is used in cardiac surgery; however, if the vein is diseased, as is the case with varicose veins and chronic venous insufficiency, it is typically unusable for heart surgery. In addition, there are other possible sources of veins or arteries in the body to use for that purpose.

A few. We request that patients limit activities that require contraction of the abdominal muscles because that causes an increase in venous pressure in the legs for 7-10 days. Such activities include jogging, heavy lifting, sit-ups, crunches and excessive stair climbing. Since we want the treated vein to close, we want to subject it to as little pressure as possible till it has a chance to heal. Walking is encouraged. You'll be back to your more strenuous activities in ten days to two weeks.

In most cases, yes. Also, remember, there are no separate hospital or anesthesiologist charges to pay because these procedures are done in our office. One of our services is to obtain pre-certification from your insurance company. Usually no, because they consider sclerotherapy to be a cosmetic procedure (ultrasound-guided sclerotherapy can often be an exception to this rule).

EVLT is less painful than open surgery and people return to work faster than after open surgery. There is less bruising and there are no incisions in the top of the leg. EVLT can also be done under local anaesthetic without the patient being put to sleep.

Remarkably painless. Most patients find they need to take painkillers for a few days only. Sometimes patients can feel the treated vein as a tender cord in the thigh after the operation, but this feeling goes away within a couple of weeks.

Remarkably few. The commonest complication is a vein irritation that lasts a couple of weeks, but very few patients get this.

Patients who have multiple risk factors for heart disease (such as male gender, smoking, high blood lipids, hypertension, a sedentary lifestyle or a strong family history of the disease) may need to preserve one of the saphenous veins, assuming that it is not already too abnormal. By combining ligation (tying the vein at the source of abnormal flow) and sclerotherapy, varicose veins can be removed while the saphenous vein is preserved.

VeNUS Closure is a surgical technique similar to EVLT. However, it takes longer to perform, has to be done under general anaesthetic and is more expensive. We do not think it is as good as EVLT.