EVLT in the News:
The Medical Post
March 23, 2004 Volume 40 Issue
Treatment performed in a clinic
and recovery takes just days
By Chris Daniels
TORONTO Doctors across the country
are embracing the relatively new procedure of laser treatment
for varicose veins.
Approved by Health Canada since March
2003, currently 13 sites and 22 certified physicians
in Canada provide endovenous laser treatment (EVLT).
The outpatient procedure delivers a thin laser via a
catheter - about the width of an angel-hair pasta noodleto
permanently collapse and seal shut damaged saphenous
A freezing solution is delivered around
the entire length of the vein to be treated and then
the laser fibre is pulled back, sealing the vein as
it is removed.
EVLT treats the main superficial veins.
Most visible varicose veins may be tributaries of these
main veins. It takes six to eight weeks for these branches
to shrink and in many cases disappear completely.
"I have been treating varicose veins
for 15 years and I always wondered if there was a better
way to remove them," said Dr. Alan Lossing, associate
professor in the department of surgery, vacular surgery
division, and co-director of the vascular lab at the
University of Toronto and St. Michael's Hospital.
He said EVLT offers a more patient-friendly
alternative to vein stripping.
"Patients like the fact that it doesn't
include general anesthetic, just local. They also like
that the procedure can be performed in a clinic. Following
SARS, the importance of not having to admit the patient
into a hospital can't be underestimated," said
Dr. Lossing. "For most people, the recovery only
requires a bit of walking around."
According to a study published in the
August 2003 issue of the Journal of Vascular and Interventional
Radiology, EVLT has a 98% success rate and a recurrence
rate of just 9%. Surgical ligation and stripping carries
a recurrence rate of about 10%. EVLT is not covered
Dr. Lossing performs about four or five
EVLT procedures a month in his Toronto clinic, even
though he has the capability to do four per day.
Not every patient is a candidate for EVLT,
he said. It is not covered by the province's drug plan
or most insurance plans so most patients opt for surgery
The cost per leg is about $3,000. "I've
approached hospitals and insurance companies about covering
EVLT but they see it as a cosmetic issue and don't want
to open that door," explained Dr. Lossing, who
says 10% of his patients have the procedure due to medical
Dr. Rolando Corpus, who runs the Centre
for Vein Care in Toronto, said he has performed laser
treatment on as many as 21 patients in one month. Since
offering it last May, he has treated more than 130 patients
using the technique.
Vein stripping traumatic:
"Stripping is a very brutal process
with a lot of bruising. It is very traumatic to the
surrounding tissues," said Dr. Corpus. "With
EVLT, a patient can be back to work within days."
Dr. Lossing and Dr. Corpus are training
doctors across Canada on EVLT for Sigmacon Health Products,
the Toronto-based distributor of the technology in Canada.
The laser costs about $50,000, plus roughly
$40,000 for the ultrasound.
EVLT is not meant to replace more traditional
treatments like vein stripping, they point out. "But
laser treatment is revolutionizing the way we treat
varicose veins," said Dr. Corpus. "I haven't
seen anything in the industry this promising in over