top of page

An EVLT (EndoVenous Laser Treatment) procedure is a frequent treatment for common superficial vein varicose veins today.

For smaller meshes of unsightly varicose veins - often about ankles, sometimes the knees, injection sclerotherapy is almost routine. 

These kinds of treatments are usually completed on an outpatient basis under local anesthesia and
sometimes oral medications to reduce patient anxiety. Compression hose and leg bandages are applied before releasing the patient to be worn for a week to limit bruising and swelling with advice to place the leg in a plastic bag for showers, etc. 

In selected situations, the patient may drive home but it is often advisable to have a driver.  

Superficial varicose veins are NOT the same as deep vein insufficiency.

EVLT procedural video link... 

https://www.facebook.com/OptimaVeinCare/videos/1193221284050203

Monocusp mini21.jpg
Monocusp mini22.jpg
File 1.jpg
DVI ulcer shin.png

     Vascular endothelium is a giant, powerful endocrine organ. The monocusp distal connection to the common femoral vein is not incised therefore, the monocusp is alive and receives its own blood supply, as result, the monocusp retains its normal hormonal capacity. 
     The monocusp, like the rest of the living vascular endothelium, secretes two important hormones -  COX-I which converts to Prostacyclin - this is a powerful antithrombotic hormone, and also Nitric Oxide Synthase III which is a powerful vasodilator. Both are highly desirable in major venous reconstruction surgery. 
     In addition, the two monocusp leading-edge 60 Prolene sutures (visible in the drawings above) at ~5 & 7 o'clock should last a lifetime.  iT IS IMPORTANT TO NOT MAKE THEM TOO LONG AND PERMIT THE MONOCUSP TO ANNEAL TO THE iVena ePTFE CLOSURE PATCH. The monocusp should be restricted to about 85% maximum open. That would lead to a failure to control the deep venous reflux typically in the Common Femoral Vein in the groin. 85% open does not result in any venous flow problems. 
     As well, the ultrathin e-PTFE iVena closure patch has a lengthy, multidecade long, successful implant history. Being ultrathin and highly flexible, it forms a small Sinus of Valsalva bulge which helps keep the superficial surface of the monocusp away from the endovascular surface of the patch. 
     This form of circulatory distal leg ulcer disease is described in the Eber's Papyrus which is dated to ~1,550BC and is the oldest medical treatise known to man. That papyrus was found between the legs of a mummy in an El-Assasif necropolis, in Luxor, not far from the Valley of the Kings, in Egypt.
     It might be of note when King Henry VIII died he was significantly obese and had distal leg ulcers. They might have been venous stasis ulcers. His corpse was stuffed in a coffin overnight but it was found to have split during the night and his royal dogs were noted to be licking up his body fluids by the next morning!

 

​FOLLOW ME

Copyright John C. Opie MD 2018

  • Facebook Social Icon
  • Twitter Social Icon
  • YouTube Social  Icon
bottom of page