Endovenous Laser Treatment
When performed well, the standard operation for varicose veins is very successful. However, like all operations there are some drawbacks. The EVLT procedure closes the thigh vein without stripping it from the body. No cut in the groin is needed and the operation can be performed completely under local anaesthetic.
The post-operative discomfort and bruising is less than with traditional surgery, and studies suggest that patients return to work faster than after traditional surgery.
How is EVLT done?
- The thigh vein is accessed though a tiny incision (2mm) just above the knee. The laser fibre is passed into the vein and positioned in the correct place with guidance from an ultrasound probe.
- Local anaesthetic is injected around the vein before activation of the laser. When the laser is turned on, the fibre is slowly withdrawn down the leg.
- As the fibre is withdrawn, the laser energy burns the inside of the vein, sealing it from the inside.
- A compression bandage is then applied to the leg and replaced with an elastic stocking before you go home.
What can I do after the operation?All normal activities (walking, bathing etc) can be carried out straight away. The only major thing advised against is heavy gym workouts.
How successful is EVLT?If you have EVLT under general anaesthetic, all the varicose veins can be removed in one procedure. If you have the operation under local anaesthesia, about half will need to return for another procedure to remove residual varicose veins below the knee. The various options can be discussed with your surgeon at the time of initial consultation. Any small thread veins remaining in the skin can also be treated at a later stage by laser or the veinwave technique.
What are the advantages of EVLT?
- No scarring
- No cut in the groin
- Less bruising
- Faster recovery
- Can be done under local anaesthetic
- No overnight hospital stay needed
What are the drawbacks of EVLT?The adverse events after EVLT have been relatively few. Occasionally patients get some redness in the skin of the thigh. Immediately after the operation the vein in the thigh can be felt through the skin like a tender ‘cord’. This goes away over the course of a few weeks as the inflammation settles down. Rarely, some patients get a feeling of numbness or altered sensation over the vein. Again, this usually settles over a few weeks.
In rare cases, EVLT cannot be successfully performed. This is usually because the varicose vein is very tortuous and the guidewire will not pass up the vein into the top of the leg. In such cases the veins can be treated by standard surgery.