Skinergy Dermatology | March/April 2015
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Endovenous Laser Treatment Ablation (EVLA)

Varicose veins are more than just cosmetic issues, they are a sign of venous reflux disease. In venous reflux disease, blood that’s pumped back to the heart pools inside a vein, causing congestion and enlargement of the vein. Visually, these veins appear as twisted, rope-like cords on the legs. For many patients, these veins can cause achiness, pain, swelling, and throbbing.

Fortunately, newer minimally invasive procedures have made it possible to treat patients in the office without vein stripping or hospital stay. Treatments for veins include ambulatory micro-phlebectomy, foam sclerotherapy, and Endovenous Laser Ablation (EVLA).

Dr. Margaret Mann, Assistant Professor, Case Western Reserve University School of Medicine and Director of the University Hospitals Westlake Aesthetic and Laser Center, a nationally known expert and speaker on venous disease, non-invasive cosmetics and more, says of EVLA, “The entire procedure is done in the doctor's office and takes less than one hour under local anesthesia. The patient is awake during the procedure with little to no pain. Following the procedure, the patient is up walking in 5-10 minutes and back to normal activities in 2-3 days.”

The procedure is performed under ultrasound guidance and treats the underlying cause of varicose veins by permanently closing off the diseased vein to any future blood flow. Dr. Mann describes the procedure, “A thin laser fiber is threaded into the diseased saphenous vein through a tiny (2mm) incision. The fiber is directed to the uppermost portion of the vein, the laser is activated, and the fiber is withdrawn. The laser gently heats the lining of the vein and safely seals it shut. The body then naturally uses other healthy veins to return blood from the heart.”

Dr. Mann is particularly excited to introduce a new sclerotherapy treatment for large varicose veins to her practice in the next few months. “I have been using sclerotherapy to treat small veins for more than 10 years, but there is a new foam medication that was recently FDA approved that will allow us to treat large veins without any surgery”. A foam solution is injected into the vein under ultrasound guidance causing the vein to seal shut immediately.

All of these procedures are done in the office and require no general anesthesia. The benefits of these treatments include rapid relief of symptoms, quick recovery, and minimal bruising or scarring.

Dr. Margaret Mann Website

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