About Endovenous Laser Treatment (EVLT)
EVLT is a procedure that uses a minimally invasive endovenous laser to treat varicose veins and is a clinically proven alternative to traditional and painful ligation and stripping surgery. It requires no general anesthesia and offers minimal risk and a shorter recovery time.
After local anesthesia is administered, a laser fiber is inserted through a small incision in the skin to access the faulty vein. The laser delivers a precise dose of energy into the vein wall, collapsing it. This process, called ablation, cures the condition and diverts blood flow to nearby functional veins which now have the opportunity to function correctly. The resulting increased circulation significantly reduces the symptoms of varicose veins and improves their cosmetic look. The collapsed vein soon shrinks and disappears.
How EVLT Ablation works
Energy generated by the laser irritates the vein walls, causing them to shrink and slowly disappear. The vein can no longer carry any blood through it. Because these veins are superficial, they are not important in transferring blood to the heart, an activity carried out by the adjacent functional veins.
Will Losing this vein cause problems?
No. The destroyed saphenous vein is not healthy in the first place and is of no use. The deep veins, however, are not altered by the laser as will continue to carry blood away from the legs.
Conditions that can be treated
EVLT is considered to be the gold standard for treating both large and small varicose veins. The success rate of our EVLT procedure is as high as 98 percent – measurably better than any other alternatives.
Strip surgery (surgically removing varicose veins) is an alternative treatment. This procedure is performed under anesthesia, is painful, has a longer recovery period, and will leave a scar.
While sclerotherapy can effectively treat small varicose veins, it is not generally used to treat large varicose veins, as it has a high recurrence rate requiring multiple treatments.
The Best Candidates
EVLT may be recommended for larger veins that are too large to effectively treat using sclerotherapy.
Patients who are pregnant, have had a recent blood clot, have arterial occlusive disease, or who are in poor general health are not good candidates for EVLT.
In the consultation your health history will be discussed, along with your medical and cosmetic goals for the outcome of the procedure.
Your evaluation includes a visual and physical examination of the legs and feet by a physician, who checks for inflammation, areas that are tender to the touch, changes in skin color, ulcerations and other signs of skin breakdown.
In most cases an ultrasound test is ordered to determine if the valves in the veins are functioning properly and to check for evidence of any blood clots.
Following that, your treatment alternatives will be discussed. These options will include sclerotherapy, EVLT and vascular/pigmented lesion lasers.
How EVLT is performed
The procedure is performed in Sante’s non-hospital surgical facility.
The vein being treated is identified from a point of origin just above the knee, and the entire leg area is cleaned with an anti-septic ointment. A small amount of local anesthetic is applied and an inducer (a guide for the laser fibre) is placed in the vein. A small laser probe is inserted through the vein. The probe is then identified with ultrasound to verify its position within the vein and then the laser is slowly heated using low energy. The laser energy damages the vein walls causing them to shrink and eventually leads to closure of the vein. The body gradually absorbs the destroyed vein tissue.
The procedure is relatively painless and takes approximately 20 minutes for each vein being treated. Once the vein is treated, the probe is removed and a small dressing is applied. A compression bandage is applied and worn for one week. The patient is usually discharged within one hour.
Following your Procedure
This procedure leaves no scars. Patients experience almost immediate relief from symptoms, but can have some minor soreness and bruising. These side-effects are temporary and can be treated with over-the-counter pain medication. Patients can usually resume normal activities immediately with minimal or no pain. A follow up appointment is made with your physician 1-2 weeks post-procedure.
Risks and potential complications
As with any invasive procedure, there are potential complications. Complications are rare, and include:
- Mild numbness around the thigh area
- A pulling sensation which can last for a week or so
- Redness and tenderness of the skin (Phlebitis) is quite common but is mild in nature and easily treated with over the counter pain medications. Most cases of phlebitis resolve in 3-7 days.
- Deep venous thrombosis. This is a very rare complications following Endovenous Laser Ablation. The best way to prevent this rare complication is to wear compression bandage or compression stocking and to walk right after the procedure.
- Infection at the incision site occurs rarely, and will usually resolve on its own.
- Mild bruising which typically resolves within a week.
- On rare occasion, an EVLT procedure may fail to successfully treat symptoms. Failure may be related to the inability to place the probe in the vein. Other causes of failure are the inability of the laser to destroy the vein. The majority of technical failures are related to inexperience of the physician.