北青山Dクリニックは、下肢静脈瘤/椎間板ヘルニアのレーザー治療、内視鏡検査、がん遺伝子治療などの医療を提供しています。

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EVLT

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EVLT

About EVLT

EVLT is an alternative to stripping the vein. A small laser optic fiber is inserted into the varicose vein. The laser is activated and, as the optic fiber is moved through the vein, it gently heats and closes the vein. Once the vein is closed, the blood that was circulating through the vein is naturally re-routed to other healthy veins. Over several-month period of time, the varicose vein is absorbed by the body and disappears.

EVLT is as effective as Surgical Stripping for treatment. The treatment is done under a local anesthesia and EVLT is non-invasive and leaves no scarring or signs of surgery. Unlike surgical stripping there is no need to remove veins and therefore almost no risk of bleeding.

Procedures of EVLT

EVLT is performed under a local anesthesia. A cut of about 1 cm is made in the knee and a optic fiber is inserted into vein; without an incision a small needle is punctured into the leg and a optic fiber is inserted into vein; a very thin laser fiber is inserted towards the toes after ligation through 2-3 cm incision at the groin.

Followings are the EVLT Procedures:
  1. 1. Visit D-Clinic
  2. 2. The doctor performs ultrasound consultation and marks the target points with a marker.
  3. 3. An intravenous drip is placed into your arm in our operation room.
  4. 4. You will be asked to lie on your back, flexing the knee to be treated slightly.
  5. 5. The doctor will sterilize your leg and cover it with a clean operating cloth.
  6. 6. Regional anesthesia will be given and then an incision (about 1 cm long) is made to reach the target varicose vein.
  7. 7. A Catheter is then inserted into the venous.
  8. 8. Regional anesthesia is given under the guidance of ultrasound. (You may feel a slight pain during this procedure.)
  9. 9. Laser Fiber is inserted into the catheter and then, the catheter is removed from the vein.
  1. 10. A Laser Fiber is placed, guided by ultrasound and a laser is activated as the fiber is withdrawn from the venous (about 5 minutes). You should feel no pain during this procedure.
  2. 12. The incision is then tied and you will be asked to wear a compression stocking.
  3. 13. The whole procedures takes about 40 minutes.
  4. 14. Then you will be moved to the recovery room.
  5. 15. After a 20-minutes-rest, the nurse will explain aftercare procedures.
  6. 16. And you will be asked to make a reservation for the next treatment.

Precautions

Food / Drinks
Breakfast as usual but please refrain from eating lunch. Water or tea before the treatment is fine.
Clothing
It's best to wear loose pants or a long skirt and bring a hat large enough to cover bandage s after surgery. Heels, jeans or short skirts not recommended.
After Treatment
It's best to arrange for someone to pick the patient up after the treatment, Patient will be ready to leave within 1-2 hours after checking-in
Medication
Regular medication is acceptable except those specifically instructed not to take before the treatment. Medication for high pressure, should be taken prior to the surgery.Contraindications are blood thinners such as, Bufferin, Byaspirin, Warfarin, Panaldine, etc.
Transportation
Public transportation is fine post-treatment. Driving after the treatment with the right leg not recommended.
Health conditions
Treatment should be avoided if a patient has any illness such as cold. The patient should call the clinic if possible prior to the appointment date or appointment time and rearrange the schedule for treatment. Treatment during menstration is fine.
Bathing
Bath or shower prior to the surgery. It is advised not to shower for 2 days after the treatment.

What is the advantages and disadvantages of EVLT?

Advantages
  • 1. Minimally invasive
  • 2. Quick treatment that requires few visitations
  • 3. You can return home after a short stay (about 20 minutes) after the treatment.
  • 4. No need to wear compression stockings.
  • 5. You can resume most activities shortly after each session.
  • 6. Minimal side effects and minimal scarring
Disadvantages
  • 1. EVLT is not covered by health insurance.
  • 2. Long term observation (over 10 years) has not been reported yet because this is newly developed treatment, while short term (2 years or more) follow up results have been clinically proven.

A Comparison of Treatments

  Stripping EVLT
Side effects (bruising / pain) Higer risk Lower risk
Approximate time required 1 - 1.5 Hours 20 Min
Surgical bandage Yes No
Hospital visit More Less

Who is the candidates for EVLT?

All small or large saphenous vein varicoses can be treated effectively. Patients, with varicose veins in the groin running just under the skin or severely twisted and gnarled, are not subjects for EVLT.

EVLT is a standard treatment option everywhere in the world except Japan. Unfortunately, there are few medical institutions which provide EVLT in Japan. There is also no likelihood that public national health insurance cover this treatment. Therefore EVLT might not be a recommended option for all patients.

Currently, we can perform Surgical Stripping without a hospital stay, which is often required elsewhere. So even those who do not choose EVLT can have Surgical Stripping or other treatment under coverage of health insurance.

We hope this clarifies your treatments options and can choose the best and most satisfying treatment according to your needs.