No, I don’t recommend either EVLT or RFA treatments for my patients.  There are a still a lot of clinics that use those treatment methods but the San Diego Vein Institute does not.  The rationale is based on the associated risk for the treatments as well as the lack of results that they often achieve.

Both treatments involve inserting a fiber into the Great Saphenous Vein itself to ablate (kill) it.  The technology is different for each method.  The EVLT treatment involves using thermal energy to collapse the vein.  The RFA treatment uses radio frequency energy to accomplish the same goal.  Theoretically since the Great Saphenous Vein is the trunk that feeds the varicose veins, killing it should resolve/remove the unsightly veins.  The reality is that that often doesn’t occur.  I’ve had made patients come to me after receiving EVLT or RFA treatment because it failed to remove the unsightly vein(s).  Not only did they not see the results they were looking for but they collapsed the Great Saphenous Vein for no reason.

My goal is the ensure that I only collapse the veins that are either unsightly or hurting the patient.  Since the San Diego Vein Institute promotes going vein-by-vein your treatment time, we ensure we are both ablating the right veins correctly and there is no unnecessary damage to healthy veins.

However, the benefits for the patient are more than just better visible results and less damage.  One drawback of EVLT or RFA treatments is that they typically go hand-in-hand with a procedure called ambulatory phlebectomy.  The downsides to ambulatory phlebectomy is that it involve small incisions (which can lead to some scarring) as well as the use of anesthesia.  Essentially, ambulatory phlebectomy is a slightly advance form of the old vein stripping treatments of the past.

The San Diego Vein Institute is a proponent of using ultrasound guided foam sclerotherapy.  Not only is it far less invasive but the recurrence rate is closer to 10% as opposed to the near 50% reoccurance rate with other treatment methods.

If you have consulted with surgeons that have recommended EVLT or RFA treatment methodology, we are happy to offer a free consultation where we can provide a second opinion.