Varicose veins & treatments Part 2

Endovenous laser treatment (EVLT) is a novel procedure that removes varicose veins in the thigh area. The procedure is done as an outpatient. The leg is cleaned and a small needle is placed in the lower thigh area where the varicose vein is located. Using ultrasound, a small laser probe is passed into the varicose vein up to the groin. The laser is switched on and gently pulled. The heat from laser burns the veins and within 20 minutes, the procedure is done.

This procedure does not treat varicose veins in the lower leg and is also expensive.
Many other procedures have been developed along the same lines. EVLT is probably the most abused procedure by surgeons. Even individuals who do not have symptoms or have very small varicose veins are treated this way. One has to understand that this same vein is often used for open-heart surgery or other bypass procedures. Despite the massive marketing behind this technique, one should be aware that a normal or mildly diseased varicose vein should never be removed. You never know if you may need the vein in future for heart surgery. The treatment of mild varicose veins is never surgery.

Closure procedure: The closure procedure is the same as EVLT except that it uses radiofrequency waves instead of a laser to generate heat.

Both EVLT and the closure procedure are considered cosmetic surgery. Both procedures have the potential to cause burns, scars, and damage to surrounding tissue. Recurrences are also very high with these two procedures,

Trivex procedure: Not to be outdone by EVLT and closure, now we also have TriVex. This simple procedure which requires anesthesia, uses a camera to identify the vein. Through a small skin incision, a thin camera on a wire is introduced and using special hook and clips, the vein is either cut or removed. Trivex requires multiple small incisions. The only difference here compared to ambulatory phlebotomy is that a camera is used.

Because of the lure of quick money, many physicians recommend Trivex and remove normal veins or veins with minimal varicosities.