Varicose Vein Doctors

As Published in M.D. News …  Treating Varicose Veins   – It’s not what it used to be  by Bruce R. Hoyle, M.D.

As Published in M.D. News …

Treating Varicose Veins

– It’s not what it used to be

by Bruce R. Hoyle, M.D.

Endovenous laser treatment (EVLT) involves inserting a laser fiber in the vein and, under ultrasound guidance, threading it into position, such as 1–2 cm below the sapheno-femoral junction. The laser is then turned on. As the fiber is pulled back, the laser causes a thermal injury to the intima or lining of the vein, resulting in thrombosis or closure of the vessel. There is another device that works on similar principle but uses radiofrequency energy instead of laser energy to destroy the intima. These procedures are an alternative to stripping. In veins that are not accessible to these devices, there are other new interventions.


While Sclerotherapy has been around for decades, there are newer solutions and new ways of delivering these solutions. To treat deeper refluxing veins in the subcutaneous tissues, a needle can be placed under ultrasound guidance into the vein and a sclerosant injected. This is known as ultrasound guided sclerotherapy (USGS).



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