Laser Vein Ablation (ELAS,EVLT)
ELAS™, also known as EVLT, stands for Endoluminal Laser Ablation of the Saphenous Vein. It is a revolutionary treatment for varicose veins that virtually eliminates the need for older surgical procedures such as “leg vein stripping” or ligation operations. It is revolutionary because it can be performed with the patient awake and able to walk home after. The ELAS™ is appealing to patients and physicians because it eliminates much of the pain, bruising, discomfort and complications of the surgical options and allows patients to go back to their normal activities quickly.
How is the ELAS™ done?
A small intravenous needle is inserted into a vein around the knee. Dr. Landi then passes a tiny laser up into the large leaky vein, the Saphenous vein, which is the cause of the varicose veins and multiple large and small leg veins. The laser is simply turned on while the laser filament is being slowly withdrawn from the saphenous vein, resulting in injury to the vein wall and permanent closure of the vessel. The ELAS™ procedure is 97% successful in closure of the saphenous vein. At the end of an ELAS™ Dr. Landi can then quickly and simply remove any enlarged varicose veins using a tiny vein hook, through a procedure called Microphlebectomy.
Why do I need an ELAS™ procedure to treat my smaller Leg Veins and Spider Veins?
Old fashioned spider veins treatments often ignored the leakiness of the saphenous vein (called Saphenous Insufficiency). Because the saphenous vein leaks venous blood under high pressure back into the spider vein system, sclerotherapy or laser alone, or even in combination, was doomed to high failure rates and recurrence. Hence, in the past, lasers and sclerotherapy got a bad name because patients felt that they did not work. If you control the leakiness of saphenous vein and the high back pressure of venous blood it creates, then the treatment of spider veins will be very successful. The problem in the past was that the only solution to leakiness of the saphenous was a leg vein stripping and its morbidity made the procedure unappealing to patients and physicians. With a simple outpatient office treatment like ELAS™, patients can now expect a high degree of success in clearing their legs of unwanted veins.
How do I know if I have Saphenous Insufficiency?
Dr. Landi will perform a non-invasive, high tech, color duplex Doppler scan of your leg vein system to diagnose any leakiness, or insufficiency of the saphenous vein.
Is the ELAS™ and Microphlebectomy painful?
The ELAS™ and microphlebectomies are extremely well-tolerated and discomfort is controlled through the use of local freezing. There is no need for general anesthesia.
What happens after the ELAS™?
The patient is placed in a leg wrap dressing and can easily walk and return immediately to light activities. After several days, the ELAS™ patient returns to the office and has the dressing removed. The patient is then placed in compressive support hose that are worn for several weeks.
What About my Spider Veins?
After the ELAS™ has controlled the large back pressure of venous blood, the physician can then treat, with great success, the small leg veins and spider veins that are often the biggest source of cosmetic concern.Dr Landi will often use a combination of high tech sclerotherapy utilizing various solutions such as polidocanol, sodium tetradecyl and glycerin in varying concentrations to eliminate the smaller leg veins and spider veins. Each session takes between 15 – 30 minutes and most patients will need between 3- 8 sessions to achieve excellent cosmetic improvement. After a leg vein and spider vein treatment, patients may return to normal light activities in compressive hose to achieve optimal control.
Will my Spider Vein and Leg Vein Treatments hurt?
No, these treatments are made very comfortable and tolerable and do not require any type of anesthesia.
What Kind of Success Rate Might I Expect?
The ELAS™ is 97% successful in the control of saphenous insufficiency and the treatment of varicose veins. Sclerotherapy of small leg veins and spider veins commonly results in 70 – 90% improvement in the cosmetic appearance of undesirable leg veins.
Will my Insurance Cover the ELAS™ and Spider Vein Treatments?
We will attempt to have your ELAS™ and spider vein treatments covered by your insurance company. However, in many states and countries, some insurance companies will not cover high tech therapies such as the ELAS™ and Spider Vein treatments, as they view these treatments as cosmetic and therefore, unnecessary. In these instances, you will have to pay the physician directly.