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Vascular Surgery/Varicose veins, venous ulcers, ELVIS procedure?

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Question
Hello Lauri,

I am a 59 year old male, a retired health care worker, and due to my former job of being on my feet 8 hours a day I developed venous ulcers in my legs.  Prior to that I experienced bilateral edema, some neuropathy in my feet, and shortness of breath. And no, I am not a diabetic (I have been asked this question numerous times).

You probably have already guessed by now, I had coronary and peripheral artery disease and eventually had a heart attack while at my job.  I had a CABG x3, during which they removed a partial vein from my left leg, just below the knee.  This was in Dec 2011, and since that time I have retired and for the past 8 months have been getting treatments for my ulcers at a local wound clinic. Before that started I was trying to treat the ulcers myself, but they weren't improving.  I was not using compression for the edema as it is so difficult for me to apply wraps or deal with compression stockings by myself.  (I live alone).

The reason I am writing to you today is the doctor at the clinic suggested I have the ELVIS procedure for my varicose veins, which I understand is similar to a heart cath but uses a laser. Scans show that I have damaged sphincters in my lower leg veins, probably due to many traumas in my football playing days of my youth. My right leg is much more severe than the left.  She gave me some literature on the procedure and from it's description I have reservations about going through with this.  The doctor at the clinic was basically a GP so she was not as informed as you on this subject, which is why I am asking your opinion.  

The info I read on ELVIS says there is a possibility of complications.  I do not want anything else to go wrong, so this is why I am hesitant about having this done.  If I knew this would eliminate the edema, which in turn would stop the ulcers from forming, and eliminate the need for compression hose, I may be more apt to have it done.  I just don't want any more health issues, I have enough already. I hope you can understand.  So, can you give me some of the pros and cons of this procedure? I need help making this decision.

Thank you,
Gary

Answer
Which vein did they use?
Were ulcers non healing surgical wounds or actual venous ulcers from edema and venous symptoms?
How long to heal ulcers? What finally worked to heal ulcers?
On your scan, do your deep veins reveal disease? If so, which veins and what do scans show?
What compression (compression strength and how high…knee or thigh)
Reservations, of course but complications WILL occur with this disease, may occur with treatment. Depending on level of your disease you may need compression hose forever with or without surgery (ELVS)
We do vein closure as well, the process is the same, just we use radiofrequency heat and ELVS uses laser heat, let me know and with that additional info, I may be able to give you info re pros and cons


if you are still having problems with compression.....

http://www.circaid.com/products/juxta-lite/jl_standard.php

this is link to easy to wear, apply compression garments with consistent compression (several strengths) (I have nothing at all to do with the garment or company, just a great product for folks w problem w standard compression) lauri

Vascular Surgery

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Lauri Ordway

Expertise

I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.

Experience

I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

Education/Credentials
I am an LPN, licensed in Minnesota

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