What Is EVLT?
Laser Treatment (Endovenous laser therapy or EVLT) involves passing a laser fibre into the vein using ultrasound monitoring. It has been approved by the National Institute for Clinical Excellence (NICE), which assesses the safety and effectiveness of medical treatments, and it has also been approved by the major private health insurers.
Advantages of EVLT over Conventional Surgery:
• EVLT is an outpatient procedure that takes 30-45 minutes per leg
• There is no general anaesthetic and there are no surgical incisions
• You can return to normal activities almost straight away
• You can return to work within just a few days
• There is very little discomfort or pain after the procedure
When you come for the procedure, you will be seen by a nurse who will check your blood pressure and answer any questions you have before the treatment. The procedure is performed by a Consultant Interventional Radiologist. The procedure begins with an ultrasound scan to mark the position of the vein in the leg to be treated. An injection of local anaesthetic is given to freeze the skin over the vein. A small needle is then inserted into the vein and a flexible guide-wire is passed up the vein toward the groin. A fine tube (sheath) is then passed over the wire into the vein and the laser fibre is threaded through the tube. Further local anaesthetic is given up the whole length of the vein to minimise any discomfort when the laser is turned on. As lasers are a powerful source of energy, you and the staff will wear protective glasses when the laser is being used. The laser is turned on and the laser fibre slowly withdrawn from the vein. As it moves the laser fibre closes up the vein from the inside. You will not feel this.
When the whole vein has been treated, the laser fibre is removed and bandages applied to the leg. You should keep the bandage on for 3 days and then wear a support stocking (which we will give you) for 2 weeks. During this time it is advisable to walk as much as possible.
After Endovenous Laser Therapy treatment you will be asked to walk around for a few minutes before you go home. You should not drive yourself home.
Follow-up Clinic Visit
You will be seen in clinic 4-6 weeks after the treatment. By this time most of your varicose veins will have shrunk down or even disappeared completely. If some do remain they can be treated by injection (UGFS). Vein injection is a routine outpatient procedure which is well established for treating less severe varicose veins.
What Should I expect after EVLT?
During the next few days you may feel some discomfort or tightness over the treated vein.
Pain killers such as paracetamol or ibruprofen may be taken to minimise this. If you have continued or increasing pain, you should contact us to seek medical advice.
Normal activity, including work can be resumed as soon as you like, but we suggest that you avoid contact sports, swimming and the gym for 2-3 weeks after the treatment.
When you remove the bandage after 3 days, minor bruising over the treated vein and slight hardness under the skin is normal. These will settle down.
What are the results of EVLT?
Endovenous Laser Therapy has not been performed for as long as conventional surgery but the results of Endovenous Laser Therapy over the past few years have been at least as good as those from surgery. After any method of treating varicose veins the veins can come back in a small number of people. If this happens Endovenous Laser Therapy can be used again, or conventional surgery can be performed.
What are the complications following EVLT?
Complications following Endovenous Laser Therapy are very uncommon. There is approximately 3% risk that the vein will not be obliterated. Excessive bruising or tenderness is seen in about 5% of patients and around 10% develop some phlebitis. Finally, about 2-3% of patients may experience some slight numbness in the lower leg following Endovenous Laser Therapy. This is nearly always temporary but can take a few months to settle down.