Questions

Which is better between EVLT and Venefit closure of the saphenous vein?

Both technologies are FDA approved and are nearly 100% successful in closing average-sized saphenous veins. The high-temperature laser treatment seems to produce more post-procedure burning-type pain and soreness but can be effective in treating significantly large veins. The upgraded Venefit system uses lower temperature pulses that is as effective without the painful side-effects and is my preferred approach.

Is this the same as vein stripping? I don't want that surgery.

Years ago vein stripping was one of the few surgical options for varicose veins. Fortunately, vein stripping is rarely needed with today’s modern varicose vein treatments. The vast majority of vein treatments are done out-patient and do not require general anesthesia. Afterwards, most patients are pleasantly surprised at how comfortable they are throughout the treatment and can immediately resume normal activities.

Will my legs look better?

Often treating the underlying cause can reduce the appearance of varicosities and spider veins. A follow-up evaluation 3 months after ablation will show what, if any, cosmetic treatments will be required. Fortunately, these cosmetic treatments rarely need to be repeated every few couple once the underlying cause has been corrected.

Will my insurance or Medicare pay for saphenous vein ablation or sclerotherapy?

In most cases, yes. Also, remember, there are no separate hospital or anesthesiologist charges to pay because these procedures are done in our facility. One of our services is to obtain pre-certification from your insurance company. All costs and insurance benefits are reviewed with you ahead of time. We want to make sure your treatment is affordable. In some cases, your out-of-pocket costs may be low or nothing at all.

For treatment of spider veins there is usually no insurance coverage because most insurers consider sclerotherapy to be a cosmetic procedure.

Is destroying the saphenous vein harmful?

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 or closing 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.

Isn't the greater saphenous vein the one used in heart bypass surgery? What if I need it for that?

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.

After the saphenous vein is occluded, or closed, can it grow back?

In theory, blood flow can resume. However, the probability of the saphenous vein reopening appears to be no more than 5-10% out to 3 years. One published report found that at 2 years 90% of Venefit treated veins were invisible to ultrasound, suggesting permanent obliteration.

Is there any restriction in activities following saphenous vein ablation?

Not really. We recommend that patients limit activities that increase in venous pressure in the legs for 7-10 days although there is little evidence to support this restriction. Theoretically, since we want the treated vein to close, we want to subject it to as little pressure as possible until it has a chance to heal. Such activities include heavy lifting, sit-ups, crunches and weight-lifing with breath-holding. Walking is encouraged. You'll be back to your more strenuous activities in ten days to two weeks.