| How it works |
A laser fibre is placed inside the vein. The heat causes the blood and vein wall to coagulate, and the vein shrinks and eventually fibroses. The vein is closed from the inside. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — how would you describe adhesive closure to a patient, in one sentence?] |
The vein is physically removed through incisions. |
An agent is injected into the vein through a needle, making it shrink and disappear. [CLIENT TO CONFIRM: Dr Davidson — our sclerotherapy is liquid. Do you want foam described separately here?] |
| Anesthesia |
Local anesthetic only. No general anesthetic and no sedation. A topical anesthetic goes on 30 to 45 minutes beforehand. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — what anesthesia does adhesive closure require?] |
General anesthetic. |
None. |
| Setting |
In our office. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — office or hospital?] |
Hospital operating room. |
In our office. |
| Typical procedure time |
About one to two hours in total. The laser itself takes minutes; the preparation, ultrasound and tumescence take the rest. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — typical procedure time?] |
[CLIENT TO CONFIRM: Dr Davidson — typical procedure time for ligation and stripping?] |
[CLIENT TO CONFIRM: Dr Davidson — typical time for a sclerotherapy session?] |
| Compression stockings after |
[CLIENT TO CONFIRM: Dr Davidson — do EVLT patients wear compression afterward, and for how long? The site does not say] |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — is compression used after adhesive closure?] |
[CLIENT TO CONFIRM: Dr Davidson — compression after stripping surgery?] |
Fourteen days. This is part of what makes the treatment work rather than an optional extra. |
| Return to normal activity |
Most patients walk out and resume normal daily activities immediately. You walk for 30 minutes before getting into a car. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — expected return to activity?] |
A recovery measured in weeks. |
Avoid exercise, hot baths and alcohol for two to three days. |
| Long-term evidence base |
Studies show endovenous laser treatment is more effective than ligation and stripping, with significantly less pain and a shorter recovery. [CLIENT TO CONFIRM: Dr Davidson — approve the citations: NICE CG168, and Rasmussen LH et al., Br J Surg 2011] |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — how would you characterise the published evidence, without making claims about any clinic's results?] |
The comparison above is the one the published studies make. |
[CLIENT TO CONFIRM: Dr Davidson — how would you characterise the evidence for foam sclerotherapy?] |
| Typical cost range in Canada |
We have found no Canadian health insurance companies that cover the cost of this procedure, and we provide information to help you make a coverage request. [CLIENT TO CONFIRM: Dr Davidson — may we publish a price range?] |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — do you want a cost range published for comparison?] |
Covered financially by provincial health plans. |
Private and public payment options are available depending on your situation. [CLIENT TO CONFIRM: Dr Davidson — may we publish a price range?] |
| Best suited for |
Larger refluxing veins, typically a refluxing saphenous vein found on ultrasound. |
Not offered at Valley Medical.
[CLIENT TO CONFIRM: Dr Davidson — which patients is adhesive closure best suited to?] |
Many patients have the option of surgery, and Dr Davidson can discuss whether it applies to you. [CLIENT TO CONFIRM: Dr Davidson — when do you still recommend surgery?] |
Spider veins, reticular veins and smaller surface veins. Needs a vessel big enough for the needle. |