EVLT, Sclerotherapy, Phlebectomy

Understanding Varicose Veins

Varicose veins show in individuals who are aging, pregnant, fall into the obese category, remain inactive or have been standing in line for a long time. These are internal veins in the legs that swell, get twisted and become visible under the skin. It occurs because valves in the veins weaken or fail, causing the blood to pool and form a bulge. The symptoms are often detectable: leg pain, feeling heavy or tired, swelling, itching, frequent cramps at night, and bluish or purplish veins that bulge out on the legs.

For Whom Is a Varicose Vein Treatment Necessary

Symptoms that qualify patients

• Legs that feel sore, heavy, or painful, or you feel tired while standing or walking
• Visible bulge of the vein, itching, or a change in the colour of the skin
• Painful, swollen veins that are visible in a purplish/bluish colour

The right candidate for EVLT, sclerotherapy, and phlebectomy

• Patients having varicose veins of medium to large size (EVLT or phlebectomy)
• Patients having smaller varicose or feeder veins, reticular or spider veins (to be treated using sclerotherapy)
• Those patients seeking vein treatment in a less invasive manner than traditional surgical options

When minimally invasive treatment is recommended

• Suffering from painful veins, but surgery is not the only option
• If looking for a quick recovery and an outpatient surgery under local anesthesia
• In situations when the ultrasound causes vein-valve reflux or proves to be insufficient

Patients who may need alternatives or additional evaluation

• In case of suspicion of other vascular diseases than varicose veins, or if there is underlying deeper venous insufficiency
• Patients who are not suitable for minimally invasive procedures or those with huge and complicated vein networks
• Individuals with prior DVT or clotting disorders who need further evaluation

When You Should Seek Treatment

Signs that you need medical care to treat varicose veins

• Constant pain, swelling or heaviness of legs
• Changes in the skin, like discoloration, ulcers or irritation along the veins
• Bleeding or recurrent swelling of protruding veins

Difference in cosmetic and medical concerns

• Cosmetic: Suitable for individuals with easily recognizable bulging veins that lower self-confidence or affect the way they look
• Medical: Suitable with patients who face pain, irritation, heaviness and swelling that interfere with daily activities and movement

Potential complications if untreated

• Alteration of the skin, pigmentation or ulcer formation
• Thrombophlebitis or bleeding risk from rupture of the veins
• Long-term pain, aggravation of vein disease or possible profound vein issues

Our Options for Advanced Varicose Vein Treatment

Endovenous Laser Therapy (EVLT)

How EVLT Works

Endovenous laser treatment involves the insertion of a fine laser fibre in the affected vein under ultrasound guidance. The laser produces the energy, which heats the vein wall, making it collapse and shut. After being closed, the veins reroute with blood to healthier veins, and the vein which has been treated slowly fades.

Conditions it Treats:

• Large refluxing saphenous veins
• Large/medium-sized veins in the legs
• Veins that result in symptoms such as heaviness, swelling and pain

Benefits of the EVLT procedure:

• Minimal epidural puncture instead of big cuts
• Generally, local anesthesia is used for the treatment
• The procedure takes less time with faster recovery and return to normal activities

Recovery and results:

• Less time loss; the majority of patients get back home on the same day
• There is a shrinking of the treated veins in the course of weeks, with better circulation and the absence of symptoms

Sclerotherapy

What is Sclerotherapy

As a minimally invasive procedure, sclerotherapy is used to treat spider veins, varicose veins and lymphatic malformations. The treatment involves injecting a solution (sclerosant) directly into the painful vein. The effect is seen when the solution causes the vein walls to swell, stick together and seal shut with time and is gradually absorbed into the body.

Types of veins it treats:

• Smooth veins of smaller size, varicose or reticular
• Spider veins and feeder veins that usually persist after the larger vein treatment

How the injection process works:

• The sclerosing solution is sprayed into the vein through a small needle
• The solution irritates the venous wall, triggering a healing process that seals the vein over time
• This is performed in the clinic and is typically not under general anesthesia

Expected recovery and improvements:

• Very little downtime; some of them get back to their regular routine in a short period of time
• The visibility of the vein gradually lessens in the weeks or months, and the cosmetic outcome improves, and the symptoms reduce

Ambulatory Phlebectomy

What Phlebectomy Treats
This is an aesthetic method of amputation of superficial varicose veins, normally side-branch or protruding veins, through tiny skin incisions. It is perfect in cases where the veins are too big or too superficial to undergo sclerotherapy.

How the minimally invasive procedure works:

• The doctor makes small, 2-3mm incisions over the vein under local anesthesia
• The vein is pulled out using a special hook/retractor through the incisions, and it does not require extensive cuts or general anesthesia

Advantages for large or bulging veins:

• Successful elimination of major varicose veins which cannot be treated with injections or laser treatment
• Quick and permanent elimination of diseased veins; good as cosmetic and symptomatic treatment

Healing and aftercare:

1. An outpatient procedure, where patients often return to normal life quickly
2. Incisions are small with minimal scars, which heal quickly with minimal disruption

How We Determine the Right Treatment

Your treatment at our clinic begins with a one-to-one conversation where our specialists talk about your symptoms and medical history and discuss your cosmetic concerns during the initial consultation. Thereafter, we carry out vein mapping and ultrasound assessment to determine the vein structure, reflux, and the affected veins. Based on these data, our experts develop a tailored treatment plan, selecting either EVLT, sclerotherapy, ambulatory phlebectomy, or a combination, which is more appropriate for your veins and objectives.

Benefits of Minimally Invasive Vein Treatments

Minimally invasive vein treatments such as EVLT, sclerotherapy, and ambulatory phlebectomy have a number of benefits, including: no use of general anesthesia, low levels of risk and reduction in time spent in recovery. Because recovery is rapid, patients are able to go home immediately or the next day; there is minimal or no scarring due to small incisions or no incisions at all; and the success rate is high, with prolonged symptom relief and improvement in vein appearance.

What Should You Expect From the Procedure

Before the treatment, every individual goes through a health checkup. For any ongoing medications, you may be advised to stop for a while. Local anesthesia (or light sedation) is administered on the day of the procedure. The doctor then uses an ultrasound to guide a laser fibre, needle, or hook, depending on the treatment. It is typically a 30-60-minute procedure and is not particularly painful for the patient, as only a few experience discomfort, which is generally mild.

The Timeline for Recovery and Aftercare

Your specialist may advise you on the following after successful completion of the procedure:

• Take brisk walks to regulate blood flow
• Wear compression stockings
• Avoid engaging in activities that require a lot of energy
• Refrain from lifting heavy objects
• Keep the treated area clean and dry

Swelling or mild pain may be present initially, but it typically gets better within a few days. The bulging vein will gradually fade, and you will be relieved of symptoms over the course of weeks. In most cases, compression stockings are continued for a few weeks to aid in healing.

Risks and Possible Side Effects

As with any medical procedure, side effects and risks may occur, including mild bruising, swelling, tenderness, temporary skin discoloration, or a small amount of pain at the treatment site. Long-term data also indicate a favourable safety profile for minimally invasive vein treatment. In case of severe pain, signs of infection, a continuing swelling, or unexpected changes to the skin, call your vascular specialist.

Results: How Soon Will You Notice Improvements?

Patients experience relief of symptoms, such as pain, heaviness, and swelling, within days to weeks of EVLT, sclerotherapy, or Ambulatory phlebectomy. Cosmetic changes occur when veins shrink and fade; the expression of visible bulging or discoloration may take several weeks to months. The majority experience long-term relief, enhanced comfort in their legs and a more natural and normal appearance of their legs.

Why Choose South Florida Vascular Associates?

Our group includes vascular experts with extensive expertise in venous disease. We incorporate the latest imaging and treatment technologies, including ultrasound-guided mapping and current laser or injection devices, to provide safe and effective treatment of varicose veins. Above all, we offer individual and patient-centred care, which means that we design treatments that suit your own vein anatomy and lifestyle and make you feel supported at each stage of the consultation and recovery.

Schedule Your Varicose Vein Evaluation

Ready to take the next step? Make an appointment with our vascular department. You can reach us either over the phone or get in touch with us using the online form to get an appointment to have your varicose veins checked. We will examine your health history, vein map, and discuss the type of minimally invasive vein treatment, EVLT, sclerotherapy, or ambulatory phlebectomy, that would be most effectively applied to you. It is time to begin with your quest for healthier, more comfortable legs.