Discover the Latest Treatment of Varicose Veins

By Pat Bitzer

Have you taken a look at your legs lately? I did and was unhappy with what I saw. It was important to me to find a doctor that could offer a non surgical solution to my problem. I found Dr. Mossavi of Nari Medical Associates in Ocean and the procedures he uses were the answer I needed. You can relieve your pain symptoms, and in the process, you will improve the appearance of your legs to restore them to a more youthful look.

What is Varicose Vein Treatment?
(EVLA-Endovenous Laser Ablation)

Varicose vein treatment, or endovenous ablation, is the latest minimally invasive treatment that uses radiofrequency or laser energy to cauterize (burn) and close abnormally enlarged veins in the legs, a condition called varicose veins. Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves which allow blood to return from the legs against gravity. If the valves leak, blood pools in leg veins which can become enlarged or varicose. Endovenous ablation is an image-guided procedure that uses heat generated by radiofrequency or laser energy to seal off these faulty vessels, diverting blood flow immediately to nearby healthy veins.

What are some common uses of the procedure?

Although this procedure may be used for cosmetic purposes, it is more commonly used to help alleviate symptoms. Symptoms are typically due to enlarged nonfunctional veins that cause circulatory problems (venous insufficiency).

Leg symptoms can include:

• aching pain
• swelling
• skin irritation or sores (ulcers)
• discoloration
• inflammation (phlebitis)

How does the procedure work?

Using ultrasound to visualize the enlarged vein, a catheter or vascular access sheath is inserted through the skin and positioned within the abnormal vein. A laser fiber or radiofrequency electrode is then inserted through the catheter and advanced to the desired location. Laser or radiofrequency energy is then applied, heating the vessel and causing it to close. Following the procedure, the faulty vein will shrink and "scar down."

How is the procedure performed?

Dr. Mossavi, a Vascular Specialist and his staff will numb the area where the catheter will enter into the abnormal vein with a FDA approved anesthetic, Sotradecol, and use the ultrasound transducer or wand to study the vein and track its path. The leg being treated will be cleaned, sterilized and covered with a surgical drape. A very small nick is made in the skin at the site. Using ultrasound guidance, the catheter is inserted through the skin into the vein and positioned within the abnormal vein. The laser fiber or radiofrequency electrode is inserted through the catheter and the tip of the fiber or electrode is exposed by pulling the catheter back slightly. Local anesthetic is injected around the abnormal vein with ultrasound guidance. Laser or radiofrequency energy is applied as the catheter is slowly withdrawn. Pressure will be applied to stop any bleeding and the opening in the skin is covered with a bandage. No sutures are needed. This procedure is usually completed within an hour.

What will I experience during the procedure?

An area of your leg will be cleaned, and numbed. You will feel a slight pin prick when the local anesthetic is injected and the area will become numb within a short time. You may feel slight pressure when the catheter is inserted but no serious discomfort. Injection of local anesthetic around the abnormal vein is the most bothersome part of the
procedure because it usually requires multiple injections along the vein. Actual closure of the vein with laser or radiofrequency is not painful. Following the procedure, you will need to wear a gradient compression stocking to help reduce bruising, tenderness, and minimize the very rare possibility that blood clots may form. You may resume your normal activity immediately, with the exception of air travel or prolonged sitting (such as a long car trip). You
should remain active and not spend too much time in bed during the recovery period since this increases the chance of complications.

Who interprets the results and how do I get them?

Dr. Mossavi and his staff will perform a follow up ultrasound examination in order to assess the treated vein. Within one week, the target vein should be successfully closed. Additional procedures (such as sclerotherapy or phlebectomy) may be necessary to treat the smaller associated veins. These procedures will remedy the tiny veins that a catheter is too large to fit in and are the final cleanup to make your legs beautiful once again!

What are the benefits of this procedure?

Benefits:

• No surgical incision is needed—only a small
  nick in the skin that does not have to be
  stitched closed.
• When compared with traditional vein stripping
  techniques, endovenous ablation is more
  effective, has fewer complications, and is
  associated with much less pain during
  recovery.
• Endovenous ablation is generally complicationfree
  and safe.
• This procedure leaves virtually no scars
  because catheter placement requires skin
  openings of only a few millimeters, not large
  incisions.
• Endovenous ablation offers a less invasive
  alternative to standard surgery.
• Most of the veins treated are effectively
  invisible even to ultrasound 12 months after the
  procedure.
• Most patients report symptom relief and are
  able to return to normal daily activities
  immediately, with little or no pain.
• Your legs will look great!