Varicose veins are dilation of the veins in the legs due to damage to the venous valves, which if left untreated will interfere with the quality of life to the point of death. Basically, varicose veins are a symptom that arises because of a disease called chronic venous insufficiency or leakage in chronic and chronic venous blood vessels. Chronic symptoms are usually progressive in nature, both the width of the varicose veins and the severity of the varicose veins. The most dangerous will cause injuries to the feet. EVLA is an alternative treatment for varicose veins which is the flagship at Hermina Pasteur Hospital
1. What is EVLA?
EVLA (Endovenous Laser Ablation) is a method of treating varicose veins by utilizing laser technology to restore the condition of swollen veins so as to minimize invasive surgical procedures.
Currently, varicose veins therapy with a laser-based approach is being developed. This laser therapy is called Endovenous Laser Ablation (EVLA).
EVLA was first introduced in Europe. Over the last 10 years this technique has been developed and has become the mainstay of therapy with only 1 day of treatment so that the patient can go home immediately, with minimal pain and no major scarring.
2. How is the EVLA procedure performed in patients with varicose veins?
EVLA is a minimally invasive treatment for varicose veins. Before this method is performed on the patient, examination using Doppler ultrasound needs to be done to determine the location of the damaged vein. Furthermore, in the area of the vein that has been marked using ultrasound, the doctor will perform local anesthesia to reduce pain during the procedure. After the anesthetic works, the doctor will make a small incision around the patient's ankle, this small incision is the access point for the EVLA device to enter the damaged vein. Then a small EVLA device is inserted into the vein. The laser at the end of the device will burn the damaged veins so that the dilated veins return to normal. After the doctor confirms that all the damaged veins have been repaired, the tool will be removed and the incision will be closed to prevent infection. This procedure takes only 20-30 minutes and does not require hospitalization so the patient can go home immediately if there are no complaints caused by the procedure.
3. Can all cases of varicose veins be treated with the EVLA procedure?
Broadly speaking, varicose veins are classified into fine (capillary) varicose veins, mesh varicose veins (reticular), and truncal (large) varicose veins. Therefore, the treatment of varicose veins differs based on the classification, location and condition of the patient. Before determining the right treatment for a patient, the doctor will usually first check the patient's condition through interviews about the patient's complaints related to varicose veins. Next, the doctor will examine the patient's varicose veins using Doppler ultrasound and determine what treatment is appropriate for the patient. Usually in mild cases that do not cause symptoms but interfere with appearance, doctors will usually choose sclerotherapy or recommend the use of stockings. In severe cases that have caused injury, pain and interfere with activities, doctors will usually choose the EVLA procedure in combination with the administration of drugs to reduce pain and as an anti-inflammatory. In severe cases with comorbidities such as diabetes, hypertension or contraindications to surgery, the EVLA procedure is highly recommended because it does not require general anesthesia and only uses small incisions.
4. What are the advantages of EVLA over conventional surgery (Vein Stripping) on varicose veins?
The advantages of EVLA over normal surgery are many. In EVLA, the time needed is quite short, namely 20-30 minutes compared to normal surgery which takes 2-3 hours for one operation. In terms of hospitalization, EVLA does not require hospitalization and patients can go home immediately after being observed for 2-3 hours. In terms of surgical scars, EVLA only uses small incisions so it doesn't damage a person's appearance and doesn't cause keloids. In terms of risk of infection, EVLA has a small risk of infection due to the small incision wound. In addition, the EVLA method was compared with open surgery and EVLA had a recurrence rate of less than 5%.
5. What things should be considered after a person undergoes treatment with EVLA?
Things that need to be considered after the patient has finished this treatment is to prevent recurrence. The effective way is to exercise regularly, avoid standing for too long, avoid using high heels, maintain an ideal body weight, and be able to use supports on the feet when resting so that the position of the feet is higher than the head. In addition, patients should also pay attention to complaints that may arise postoperatively such as pain that interferes with activities, fever and other complaints. If complaints arise immediately consult a doctor.
6. How can we consult our varicose veins problem easily and precisely?
Treatment of varicose veins aims to reduce complaints and restore the original function of the veins. It is hoped that in the future EVLA can further develop in Indonesia so that it is able to deal with varicose veins quickly and precisely.
If Friends of Hermina experience varicose veins, immediately consult dr. Romzi Karim, Sp.B Subsp BVE(K) he is a Sub-Specialist in Endovascular Vascular Surgery at Hermina Pasteur Hospital.