Answers to FAQs About EVLT & Venefit

Who is not a good candidate for endovenous thermal ablation (EVLT and Venefit)?

Varicose veins treatment with endovenous laser treatment should not be performed on candidates who are either immunocompromised, pregnant, unable to ambulate freely, and patients with

• bleeding abnormalities
• clots in the deep vein system or in the vein to be treated
• disease in the arteries of the legs
• localized or general infections
• rare arterial-venous communication in the segment to be treated

How do I prepare for endovenous thermal ablation of varicose veins?

In the week before your treatment, do not tan, stop taking any blood thinning medications, and wait for any skin infections to heal. Avoid taking NSAID medications, such as ibuprofen (Advil, Motrin). You may eat prior to the procedure. On the day of the procedure, you are advised to wear comfortable clothing and bring under clothes change, as the ones you are wearing may get stained with Betadine.

How is the recovery like following endovenous thermal ablation (Venefit or EVLT)?

After varicose vein treatment with thermal ablation, whether Endovenous Varicose Veins Laser Treatment (EVLT) or Venefit™ Targeted Endovenous Therapy, you may feel a tightness in the treated leg. This is normal and should be temporary. Mild bruising and swelling are also common. These should not be of concern, however, since they typically resolve within a few weeks. After-procedure pain level is expected to be mild and can be mostly managed with over-the-counter medications, such as Advil. Tenderness to direct manual pressure over the vein, however, may persist for several weeks.

What are the aftercare instructions following endovenous thermal ablation (Venefit or EVLT)?

Wraps will come off during the next-day follow-up visit, but compression stockings should be worn for two weeks following the procedure. Go to compression therapy and watch the video on how to wear compression stockings. As for activities, patients are encouraged to engage in moderate exercises that involve the legs, like walking, hiking, biking, or treadmill workouts. Activities to avoid immediately on the day following varicose vein treatment with endovenous ablation techniques, whether Endovenous Laser Therapy or Venefit™, include heavy weight lifting, extreme sports, abdominal crunches, and any activity that increase core body pressure. Patients should also avoid extreme hot environments, like sauna and bathtub. After the first 24 hours, the compression stockings can be taken off during sleep and while taking a shower. During the healing period, direct sun exposure and tanning should also be avoided in order to prevent skin discoloration.

When will the results of endovenous thermal ablation therapy be seen?

Symptoms of varicose veins (heaviness, aching, numbness, etc) will typically improve immediately. Dilated branch varicose veins, however, will gradually shrink over several weeks. The final results will be obvious after a few months.

What are the advantages of endovenous thermal ablation therapy?

Only an experienced vein specialist can tell you if an endovenous thermal ablation procedure is a viable option for your vein problem. The physician will usually take the decision after a complete ultrasound examination. The advantages of endovenous thermal ablation Procedures for varicose vein treatment are as follows:

• Compared to stripping surgery, endovenous thermal ablation procedures cause less tissue trauma and bruising and eliminate the need for hospitalization and general anesthesia.
• Other than the brief “stick and burn” during the injection of local anesthesia, most patients report feeling little, if any, discomfort during the procedure.
• They are covered by Medicare and most PPO health insurance plans in the United States and in several countries in Europe.
• The cosmetic outcome is excellent. Do not result in permanent scarrings, like the ones left behind following surgical vein removal.
• According to international multi-center studies, endovenous thermal ablation procedures are more than 90% effective at a 5-year follow-up.
• Endovenous thermal ablation procedures take less than an hour, followed by a quick recovery and a return to normal activities.

What is the difference between the Venefit Targeted Endovenous Therapy (formerly known as Vnus Closure) and EVLT procedures?

Venefit and EVLT procedures are almost identical, both sharing the endovenous approach (from inside the vein ), the tumescent anesthesia technique (dilute numbing medicine injection around the vein), and relying on heat energy to seal the veins shut. The only difference between the two is the way in which heat is generated. In the case of EVLT, heat comes in the form of a laser beam, whereas in the Venefit Targeted Endovenous Therapy, radiofrequency causes electrical heating and destruction (thermal ablation) of the vein.

How do VNUS closure or EVLT work to treat superficial venous reflux?

Once damaged, vein valves can’t be repaired. Accordingly, the only alternative is to re-route blood flow through healthy veins. The VNUS Closure procedure or EVLT treat venous reflux by sealing the incompetent saphenous vein or perforator vein from inside by means of either electrical heat generated by a catheter (VNUS radiofrequency closure), or alternatively, by light energy generated by a laser fiber (EVLT). Once the diseased vein is sealed, other healthy veins take over and carry blood from your legs.

Is the Venefit Targeted Endovenous Therapy better than EVLT for the sealing of the great saphenous vein?

Both technologies, Venefit (formerly known as VNUS Closure) and EVLT, work very well and are equally efficient for the ablation of the great saphenous vein. Overall, long-term data are also essentially equal.

What are the complications associated with endovenous thermal ablation therapy?

Complications associated with endovenous ablation are rare and may include skin burns and temporary superficial nerve injury resulting in limited skin numbness in the lower legs. Thrombophlebitis, deep venous thrombosis (DVT), and pulmonary embolism (PE) are other rare complications reported in the medical literature. Note that the incidence of these complications compares very favorably with that reported for surgical ligation/stripping.