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Understanding EVLT and its role in treating varicose veins
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    3. Understanding EVLT and its role in treating varicose veins

    Understanding EVLT and its role in treating varicose veins

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    What is varicose vein

    Varicose veins are twisted, enlarged veins. Any superficial vein may become varicosed, but the veins most commonly affected are those in your legs.  It happens because of defective valves in the vein that causes reflux and pooling of blood towards the direction of gravity.  

    For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.

    Symptoms

    When painful signs and symptoms occur, they may include:

    • An achy or heavy feeling in your legs, burning, throbbing, muscle cramping and swelling in your lower legs
    • Worsened pain after sitting or standing for a long time
    • Itching around one or more of your veins
    • Skin discoloration (blackening), thickening, dryness and loss of hair.
    • Leg ulcers and bleeding

    Spider veins are similar to varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and are often red or blue. They vary in size and often look like a spider's web.

    When to visit a doctor

    Self-care such as exercise, leg elevation or compression stockings — can help you from getting worse. But if you're concerned about the cosmesis or self-care measures are not sufficient from getting worse, see your doctor.

    Causes

    Weak or damaged valves can lead to varicose veins. Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

    Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the veins to stretch or twist.

    Risk factors

    • Age. Due to loss of vein elasticity some blood flows back into your veins where it collects instead of flowing up to your heart.
    • Sex. Women are more likely to develop because of hormonal changes during pregnancy, premenstruation or menopause tend to relax vein walls there by development of varicose veins. Also birth control pills, may increase your risk of varicose veins.
    • Family history. If other family members had varicose veins, there's a greater chance you will too.
    • Obesity. It puts additional pressure on your veins.
    • Standing or sitting for long periods of time. Jobs involving prolonged standing and sedentary life style. 

    Complications

    • Ulcers. Painful ulcers, particularly near the ankles. A discoloured spot on the skin usually begins before an ulcer forms. Needs urgent consultation.
    • Blood clots (DVT). Any persistent leg pain or swelling warrants medical attention because it may indicate a blood clot within deep veins (DVT).
    • Bleeding. This happens because of increased pressure.

    Prevention

    • No way to completely prevent but improving your circulation and muscle tone may reduce the risk of developing varicose veins or getting additional ones. 
    • Exercising with weight control
    • Eating a high-fibre, low-salt diet
    • Avoiding high heels and tight hosiery
    • Elevating your legs
    • Changing your sitting or standing position regularly

    What is EVLT

    Endovenous laser ablation therapy (EVLT) is a minimally invasive procedure that makes use of catheters, lasers, and ultrasound to treat varicose veins. The EVLT procedure begins with an Interventional Radiologist inserting a catheter into the varicose vein. Using ultrasound to see inside the patient, the doctor guides the catheter through the vein. A laser at the end of the catheter heats the walls of the vein, which closes it. This causes blood to stop flowing through the vein.

    As the body recovers after the procedure, circulation becomes more efficient since blood is not flowing through a faulty vein and the problem vein shrinks and fades. Blood then flows through other nearby veins instead.

    WHY EVLT

    • Outpatient procedure(walk in - walk out). Can resume normal activities immediately
    • Quick and easy to perform
    • Minimally invasive and less traumatic
    • No scarring
    • Excellent clinical result
    • Better result than open surgery
    • Reduced procedure cost

    What happens after endovenous laser varicose vein surgery?

    You will be encouraged to walk right after the procedure, for about 30 to 60 minutes.
    Your leg may have some bruising. The bruises should go away in about 2 weeks.
    You’ll need to have someone drive you home after the procedure.

    Follow up to the procedure

    Follow up with within one weeks’ time followed by next follow up after 1 month.
    You will be advised to use stockings for 2 months.

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    Testimonials

    A whole-hearted thank you to Dr. Dheeraj and team for successfully getting me out of this difficult health situation.

    Dear Dr. Dheeraj,

    Please find below a short write up on how happy I am about my experience with your treatment

    Name: Makesh

    Read More
    ‹ ›

    Dear Dr. Dheeraj,

    Please find below a short write up on how happy I am about my experience with your treatment at Sakra. Please note I wrote this more as feedback for you rather than Sakra. I couldn't find anywhere I could post this feedback directly to you (such as Google or Practo). I have posted the review on Sakra's google review page, however. Once again thank you very much for getting me out of the difficult situation I was in.

    I was referred to Dr. Dheeraj Kumar Tiwari, by my pulmonologist for loculated empyema. I had basically two options for my condition--surgery or chest tube drainage. I had three separate loculations for which surgery was the more preferred option. I was really really scared of surgery especially when I was told that the risk was comparable to a bypass heart surgery. Dr. Dheeraj analyzed my CT scan reports first and checked all my chest X-Ray images. He then did a preliminary ultrasound first and analyzed how best he could drain the loculations. He was very certain about what would work. Absolutely no hesitation whatsoever. I was asked to be admitted the next day and the procedure went exactly as he had planned. A repeat chest- X ray and a CT scan confirmed that the loculations were drained completely. It is the exact outcome I was praying for.  Since the procedure, I have had an opportunity to meet Dr. Dheeraj during several of my follow-up visits. 

    Dr. Dheeraj presents a rare combination of a doctor who is very very skilled in his trade and at the same time is very reassuring to talk to.  He will patiently answer every question of yours regardless of however elementary or irrelevant it is.  Dr. Dheeraj, in my view, recognizes the uniqueness of each patient's experience and is able to relate to the patients at a level that puts them in a positive frame of mind. Dr. Dheeraj, who has access to state of the art medical infrastructure at Sakra, is ably assisted by his junior Dr. Dheeraj Shyam and the team of nurses. A whole-hearted thank you to Dr. Dheeraj and team for successfully getting me out of this difficult health situation.

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