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ENDOVENOUS LASER TREATMENT EVLT

Pre-operative Workup

All patients require a duplex (ultrasound) scan of the veins of the leg, to confirm whether laser treatment is possible and preferable.

The procedure is performed under local anaesthetic so no major workup or blood tests are required.

 

Day of Procedure

You will be provided with a prescription for a sedative and a blood thinner, which you MUST bring on the day of the procedure.

These are administered prior to commencing EVLT.

 

The operation

The procedure is performed with the aim of closing down the saphenous vein, the vein responsible for the varicose veins. Most of the varicose veins will shrink as a result of EVLT, and will not require any further treatment. However in 20 – 30% of patients follow-up sclerotherapy is required to obliterate any residual veins. This is performed 6 to 8 weeks later, using ultrasound guidance.

The course of the saphenous vein from the knee to the groin is mapped using ultrasound guidance. After preparing and draping the leg, the saphenous vein is punctured under ultrasound guidance in the region of the knee. The laser probe is advanced to within 2 cm of the groin within a sheath, in preparation for treatment. As the laser generates a lot of heat, local anaesthetic is infiltrated around the vein to numb it and also facilitate the effect of the laser. Some may find this a little uncomfortable, but the local anaesthetic makes it much easier to then tolerate the laser.

The laser is then activated and the laser probe slowly withdrawn causing a thermal injury to the entire length of the saphenous vein. This causes the vein to shut down and clot off (thrombose), effectively eliminating from it from the circulation.

A thigh-high elastic stocking is then applied to the leg at the completion of the procedure

 

Post-operative course

Patients are encouraged to be as active as possible, within their comfort zone. Simple analgesics or anti-inflammatories may ease any discomfort.

You must wear the stocking day and night for the first week, and then during the day for the second week.

A follow-up ultrasound scan will be performed one week following the procedure, and you will be reviewed at 2 weeks.

If some of the varicose veins have failed to disappear, they will be treated by injection sclerotherapy 6 to 8 weeks later.

 

What are the complications of EVLT?

Some bruising or soft tissue thickening is common on the inner aspect of the thigh. This is in response to the thrombosis induced by the laser. It is not dangerous and gradually disappears over 2 to 3 weeks.

 

There is a risk of Deep Venous Thrombosis but the chance is less than 0.1%.

If you have any concerns, please phone the rooms to speak directly with Mr Bell.