Treatments
Endovenous Laser Treatment (EVLT)
Also known as Endovenous Laser Ablation (EVA), this is a very effective method for treatment of incompetent Superficial Trunk Veins, which are commonly the main problem underlying visible varicose veins. Dr McMaster uses EVLT to treat these veins in his rooms under local anaesthetic and ultrasound guidance.
Heat is applied directly to the inside wall of the target vein by way of the fine laser fibre which is introduced into the vein under ultrasound guidance. Prior to activating the laser, Dr McMaster will also inject local anaesthetic around the vein to eliminate any sensation and protect other structures in the leg from any heat. The lasered vein shrinks and closes, and is gradually reabsorbed by the body in the next few months. Blood flow in the leg continues through deep veins which have ample capacity.
Endovenous Laser has largely eliminated the need for vein stripping operations over the past 20 years. It is an extremely effective treatment for large “trunk” veins, is able to be completed under local anaesthetic, with minimal down time. Most patients can return to work within 48 hours, and normal day to day activity immediately. It is safe to drive home immediately following treatment.
EVLT takes up to 90 minutes for preparation, marking up the vein locations using ultrasound, applying local anaesthetic, introducing a fine laser fibre into the target vein, and lasering the veins. Dr McMaster completes EVLT in the rooms without using sedation or general anaesthetic. (Once again inhaled analgesia is available on patient request, but rarely required) The procedure is very well tolerated with minimal discomfort, and results in immediate closure of treated veins. This procedure was first used in New York in the late 1990s, and Dr McMaster has been using EVLT since 2005 to treat people in Brisbane with Varicose Veins.
After the local anaesthetic wears off a couple of hours following EVLT, most people will experience some aching in the area of the treated vein. Panadol (Paracetamol) and occasionally an anti-inflammatory medication such as Nurofen (Ibuprofen) are usually sufficient for any discomfort. Often discomfort in the legs is worst 48 hours following the procedure, and gradually settles over the following week or two. A tight sensation along the course of the vein is often present after resting, and gradually improves with movement such as gentle walking.
Yes. Unless you are acutely unwell, anticoagulant medication is perfectly safe to continue when having both Endovenous Laser and Ultrasound Guided Sclerotherapy. Bleeding is not a problem during or after these procedures, and the anticoagulant does not affect the successful outcomes of treatment.
The vast majority of the venous return in the legs is by way of the deep veins. These are unaffected by treatment of varicose veins, and have ample capacity to cope with blood flow from closed superficial veins.
The answer to this very much depends upon individual circumstances, and should be discussed with Dr McMaster. There are several options available to manage this situation.
This term is used to describe any of the means of removing leg veins by means of heating the veins from within. There are three main methods of ETA. Endovenous Laser EVLT, Radiofrequency ablation (RFA) which involves using a radiofrequency catheter to heat the vein wall from within, and MOCA which uses steam to heat the vein wall. Each of these methods has their advantages and drawbacks in the treatment of varicose veins.