Treating Chronic Venous Insufficiency with Endovenous Laser Ablation

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Revolutionizing CVI Management: Video Laser Treatment Through Endovenous Laser Ablation

Chronic venous insufficiency (CVI) is a common condition affecting the veins in the legs. It occurs when the one-way valves inside the veins stop working properly, causing blood to flow backwards and pool in the veins.

This results in a variety of symptoms like leg pain, swelling, varicose veins, and skin changes. If left untreated, CVI can worsen over time and lead to serious complications.

Fortunately, a minimally invasive procedure called endovenous laser ablation (EVLA) provides an effective treatment option for CVI.

Keep reading to learn more about how EVLA works, what to expect during treatment, and how it can provide lasting relief for CVI.

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What Causes Chronic Venous Insufficiency?

CVI occurs when the one-way valves inside the veins in your legs stop working correctly. These valves are responsible for keeping blood flowing in the right direction - from the legs up to the heart.

When the valves become damaged or wear out, blood starts to flow backwards and pool in the veins. This causes pressure to build up, stretching the veins and the valves further. Over time, it leads to the characteristic signs and symptoms of CVI.

Some common causes of valve damage that can lead to CVI include:

  • Blood clots in the deep veins of the legs (deep vein thrombosis)
  • Injury, surgery, or trauma that impacts the leg veins
  • Obesity, which puts extra pressure on the leg veins
  • Pregnancy, which increases blood volume and pressure
  • Genetics or weak vein walls
  • Prolonged standing or sitting, which allows blood to pool in the legs

Understanding Endovenous Laser Ablation (EVLA)

EVLA is a minimally invasive treatment that uses laser energy to seal off damaged veins. It allows your blood to reroute through healthier veins, restoring normal circulation in your legs.

Here’s a quick overview of how EVLA works:

  • Using ultrasound guidance, a thin laser fiber is inserted into the diseased vein through a small incision.
  • The laser fiber is threaded up through the vein until it reaches the highest point of reflux (backward flow).
  • Tumescent anesthesia is injected around the vein to numb it and compress it.
  • The laser fiber slowly delivers heat energy to the interior vein wall, causing it to collapse and seal shut.
  • Over time, the sealed vein is reabsorbed by the body. Blood gets redirected into healthier veins.

The procedure takes less than an hour and only requires local anesthesia. Many patients report an immediate reduction in CVI symptoms following EVLA.

What is Video Laser in Endovenous Laser Ablation for Varicose Veins?

Endovenous Laser Ablation (EVLA) is a key method for treating varicose veins. It uses a technique called video laser. This involves a small cut in the leg to insert a laser fiber into the varicose vein.

The video laser delivers energy to close the vein. As the fiber moves back, it heats and seals the vein. This makes the vein collapse and the body absorbs it over time. Video laser makes EVLA precise and effective. It reduces pain and speeds up recovery.

What Are the Benefits of EVLA for CVI?

Compared to traditional vein stripping surgery, EVLA offers many advantages:

  • It's minimally invasive, involving no large incisions.
  • It can be done under local anesthesia in an outpatient setting.
  • It causes very little pain or scarring afterwards.
  • There is no need for general anesthesia.
  • Recovery time is much faster, often just a few days.
  • Success rates are very high – 95% or more of treated veins remain sealed off.
  • Symptom relief starts quickly and most patients see a major improvement.

For appropriate patients with CVI, EVLA is considered the gold standard treatment approach with long-lasting results.

Who is a Good Candidate for EVLA?

EVLA works very well for treating CVI caused by damaged valves in the great saphenous vein, which runs from the ankle up the inner thigh.

Good candidates for EVLA include those who have:

  • Symptomatic CVI with leg pain, achiness, swelling, etc.
  • Varicose veins originating from great saphenous vein reflux
  • Superficial venous reflux shown on duplex ultrasound
  • Failed conservative treatments like compression stockings

EVLA may not be suitable for patients with arterial disease, deep vein thrombosis, or certain other health conditions. Be sure to discuss your medical history thoroughly with your vein doctor.

Preparing for Your EVLA Procedure

There are a few important steps to take when preparing for your EVLA treatment:

  • Medical evaluation - Have a full checkup to ensure you are healthy enough for the procedure. Inform your doctor of any medications you take.
  • Medication adjustments - Your doctor may advise you to stop blood thinners for several days before EVLA to reduce the risk of bleeding.
  • Fasting - You'll need to fast for 6-8 hours before the procedure.
    Arrange transportation - You'll need someone to drive you home after the procedure.

Following your doctor’s preparation guidelines helps ensure you heal quickly after EVLA.

What to Expect During the EVLA Procedure

The EVLA procedure is conducted in your vein doctor's office and takes 30-60 minutes to complete. Here's an overview of what happens:

  • You'll lie flat on your back with your leg slightly elevated.
  • Using ultrasound guidance, the doctor inserts a thin catheter into the diseased vein, through a small incision below the knee.
  • The laser fiber is threaded through the catheter up to the highest point of leaking valve.
  • Local anesthesia is injected around the vein. You may feel some pressure but no serious pain.
  • When activated, the laser delivers pulses of heat inside the vein, sealing the vein shut.
  • The doctor slowly pulls back the fiber, closing the vein along its full length up to the groin.
  • After removing the catheter, the doctor will close the incision with a bandage.

You'll be awake for the entire quick procedure. Many patients describe it as painless, or only mildly uncomfortable.

Recovering After Your EVLA Treatment

The recovery period after EVLA is much shorter than with surgical options. You can expect:

  • Mild discomfort - Your leg may feel sore, achy or bruised for the first week. Use Tylenol if needed.
  • Compression stockings - Wear prescribed medical-grade stockings for 1-2 weeks to prevent blood clots and reduce swelling.
  • Walking - Resume light activity immediately. Brisk walking is encouraged to boost circulation.
  • Normal activities - You can return to most normal activities within 1-2 days, besides air travel or strenuous exercise.
  • Exercise - Refrain from strenuous activities for 2 weeks. After your follow-up, you can ease back into your exercise routine.

Your doctor will want to see you for a follow-up visit 1-2 weeks after EVLA to check your progress.

How Effective is EVLA for Closing Damaged Veins?

Clinical studies show EVLA successfully closes the treated vein more than 95% of the time. In a procedure called phlebectomy, small branches of varicose veins are usually treated at the same time.

Together, EVLA and phlebectomy provide substantial relief from CVI symptoms by redirecting blood flow to healthier veins.

However, it’s important to note that CVI is a chronic, progressive condition. Some patients eventually need additional procedures to treat new problem veins that develop over time.

Lifestyle changes, medical management, and wearing compression stockings can help prolong benefits.

Does Insurance Cover EVLA Treatment?

Many insurance plans cover EVLA for treatment of CVI, especially when more conservative approaches have failed. This includes Medicare and Medicaid. However, coverage can vary by plan.

Out-of-pocket costs for EVLA average $2,000-$3,000 if insurance does not cover the procedure. Many vein clinics offer payment plans to make treatment more affordable.

To get the exact cost for your treatment, talk to your vein doctor and confirm coverage with your insurance provider. Many clinics handle all aspects of the insurance process for you.

Considering Your Options for CVI Relief? Let's Talk.

Experiencing discomfort from chronic venous insufficiency (CVI)?

While navigating your treatment options, knowledge is your first step towards relief.

Here at Vein Center Doctor, our vein specialists are here to provide insights and guidance on various approaches, including the latest advancements in minimally invasive treatments.

A consultation with us isn't just about procedures; it's about understanding your condition and exploring all available avenues for managing your symptoms effectively.

Your journey to a more comfortable life starts with informed choices. Reach out to learn more about how we can support your path to wellness.

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