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EVRFA stands for Endovenous Radio-frequency Ablation. Bilateral (B/L) EVRFA and Foam Sclerotherapy are minimally invasive and painless surgical procedures to treat symptomatic varicose veins and chronic venous insufficiency (CVI).

In the above disease conditions, veins become distended and painful with local swelling, This state can last from months to years. 

These techniques help treat such conditions effectively by collapsing the affected vein completely. The collapsed vein undergoes spontaneous absorption and clearing by the body’s natural healing mechanisms.

How is Bilateral EVRFA and Foam Sclerotherapy performed?

Before surgery:  The entire procedure requires minimal preparation and care by a nurse. The veins are visualised for blood flow by an ultrasound-guided image. 

Once the vein and area of obstruction are confirmed, the medical professional may administer local anaesthesia and select an appropriate procedure.

During surgery: In B/L EVRFA, the healthcare professional inserts a laser fibre through a small skin prick into the desired vein. This laser fibre produces heat that causes the walls of the veins to draw in towards each other, pushing up the blood. 

They then slowly take out laser fibre, after which the vein collapses and shuts close. The collapsed vein becomes fibrosed or wears off. Our body clears this waste material by absorption. The blood flow is then directed naturally through other normal veins. 

In Foam Sclerotherapy, the medical technician fills a catheter with a drug solution and then inserts air into the desired vein. The air increases the pressure inside the vein causing the cells to merge and the drug released leads to drawing in of the inner lining of the vein walls. 

As they remove the catheter, the vein collapses and starts wearing. The body reabsorbs the vein, and blood resumes flowing through normal veins.

After surgery: Doctors advise to wear a full-length stocking at all times for 7-10 days. Individuals may gradually resume all daily activities. Doctors also recommend recovering patients to walk for at least 20 minutes daily.

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Cost of the Bilateral EVRFA and Foam Sclerotherapy

Description Cost

 Cost of surgery in Hyderabad

 Rs. 5000/-per session

Cost of surgery in India

 Rs. 4000-5000/-per session

 

Surgery details Description

Number of days in the hospital

 Outpatient day care procedure

Type of surgery

Minor

Type of Anaesthesia

Local

Number of days required to recover

 One day

Duration of the procedure

 30-45 minutes depending on the number of veins

Type of surgical options available

 Minimal invasive involving laser

Risks and complications of the Bilateral EVRFA and Foam Sclerotherapy

Risks
Potential risks may arise due to associated or coexisting medical conditions.

Complications
Complications of Foam Sclerotherapy and EVRFA include:

  • Hyperpigmentation of the skin around the site of the procedure
  • The appearance of small veins
  • Small blood clots
  • Localised hair growth
  • Pain from the procedure
  • Swelling and tenderness

These complications vanish entirely within six months. It  can be minimised with appropriate care and by maintaining an active lifestyle.

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Frequently Asked Questions about Bilateral EVRFA and Foam Sclerotherapy

Foam sclerotherapy can last from months to years, as the vein completely collapses during the procedure. New veins can encroach on the surrounding areas to restore blood flow. 

However, lack of adequate care in the initial phase after the surgery may cause the new veins to turn varicose.

After a session of foam sclerotherapy, it is usually advisable to wait for 4-6 weeks before another session.The doctor will first screen the veins with ultrasound-guided imagery and advise further treatment plans as necessary. 

Associated comorbidities may delay healing, such as high blood pressure, diabetes, etc.

Although rare, we cannot overrule the chances of veins becoming varicose again. The collapsed veins do not come back unless the laser or catheter fails to close the vein down entirely during the foam sclerotherapy and EVRFA procedures. 

Even the new veins formed in the adjoining areas may turn varicose in rare cases.

Foam sclerotherapy is a permanent procedure, but complications and recurrence occur in a few cases depending on comorbidities and lifestyle. 

One should follow all necessary precautions and maintain a healthy lifestyle with physical activity consisting of walking for a minimum of 20 minutes every day to prevent reoccurrence.

Yes, a blood clot may form after foam sclerotherapy or EVRFA procedure. The chances of it are less if doctors take proper preventive measures with compliance from the patient. These measures include the patient wearing a stocking at all times for the initial seven days after the procedure.

Depending on the number of varicose veins present in the body part, the vascular surgeon or physician may advise anywhere between 1 and 4 sessions with a reasonable interval between the sessions. 

One session usually lasts for 30-40 minutes, and the results are generally seen 4-6 weeks following the procedure.

Nerve damage may occur in the form of abnormal sensations in the target area, which is usually transient and wears off once all activities are resumed. The initial distension and subsequent collapsing of veins may cause temporary damage to surrounding nerves. The chances of such an incidence are 0.02%.

Documented episodes of stroke after a foam sclerotherapy procedure are rare. Associated comorbidities such as high blood pressure and diabetes may predispose an individual to a stroke, but it is sporadic and preventable. 

Medical professionals recommend an active lifestyle before and after the procedure through physical exercise and proper nutrition.

References

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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