Endo – Venous Laser Therapy (EVLT) For Varicose Vein Treatment

EVLT or Endo -Venous Laser Therapy is relatively quick procedure, carried out under a local anaesthetic, used as a treatment for varicose veins which is only minimally invasive and is a practical alternative to some other methods of varicose vein removal such as vein stripping.

This procedure is not normally carried out to treat smaller “spider” varicose veins.

Post procedure there is minimal scarring to the skin of only a few millimetres at the point where a catheter was inserted. It leaves only one small scar about ¼ of an inch or less at the insertion site. It is performed under a local anaesthetic and the patient normally has a reasonably short recovery time with only minimal pain.

As with any medical condition or procedure you must consult your own physician for examination and to discuss the possible options for treating individual conditions. The information below is meant to give a broad overview of one particular medical procedure

 What are Varicose Veins

These are veins which have become engorged with blood and have started to bulge under the skin. The small one way valves within the veins are no longer working and the build up of blood causes the bulges.

Varicose veins can be the normal skin colour, dark purple or blue and generally (but not always) found on the lower extremes of the body.

Symptoms include aching of the affected area, itchiness, feelings of heaviness in the legs and night cramps.

Around 25 – 40% of women and men will suffer from varicose veins at one time or another and factors such as heredity, age, gender, pregnancy, being over weight, standing and sitting for long periods of time and other medical conditions, can contribute to the condition.

Without EVLT or Endo – Venous Laser Therapy the symptoms can develop into a lifestyle limiting condition and the majority of suffers will seek treatment to remove the symptoms but also for cosmetic purposes.

Endo Venous Laser Therapy (EVLT)

There are a number of treatments for varicose veins, some of which are invasive, some non invasive.

EVLT or Endo – Venous Laser Therapy is a minimally invasive procedure carried out on an outpatient basis which in most cases will allow a patient to resume their everyday lives almost immediately and has a success rate of around 95%.

Before selecting Endo – Venous Laser Therapy your surgeon will have to conduct a full physical examination in conjunction with an ultrasound scan of the leg veins which will normally be carried out separately. The ultrasound scan allows the surgeon to identify the leaking veins as they cannot always be seen by eye.

Based on the results of the examination and the ultrasound the surgeon will then decide if EVLT is appropriate for the individual.

Endo-venous means ‘inside the vein’ so with Endo- Venous Laser Therapy the whole procedure takes place within the vein “tube” and whilst the procedure is minimally invasive it requires only small incisions to access the damaged veins to block them.

In fact minimally invasive or keyhole procedures tend to reduce post procedure pain, hasten recovery and permit a normal return to activity compared to more traditional surgery.

At the start of the procedure the surgeon (or Phlebotomist) will use the ultrasound scanner to mark which veins need attention.

Please note that this procedure can be used to obtain obliteration of the saphenous vein along a damaged length.

Following this the normal sequence for procedure is generally as follows:-

• A local anaesthetic will be administered to numb the area around the vein to be treated.
• A small needle or catheter is inserted into the vein and a flexible optical fibre is pushed up through the needle/catheter towards damaged vein.
• The position of the optical fibre is continually monitored using an ultra sound scanner.
• As the fibre is finally positioned additional local anaesthetic is injected around the damaged vein to reduce any discomfort once the laser is activated.
• The laser will be activated and its beam projected along the optical fibre.  The fibre will be slowly withdrawn along the vein and as it is retracted the laser will burn and close the vein from within.
• Once closed the circulation is redirected through the existing healthy veins.
• Once the vein has been sealed the optical fibre and needle/catheter are removed and dressings are applied. These will vary between compression bandages and or support stockings which are kept in place for between two and three weeks.
• The procedure takes between 45 minutes and 1 hour depending on the severity of the condition.
• Patients are normally advised to walk around after the procedure for a period of time before being discharged. It is recommended that the patient is taken home by taxi or with a friend and avoids driving if the journey home is more than say one hour.

• Patients can normally return to a normal routine in a couple of days.
• There will be some minor discomfort for a few days and painkillers are normally prescribed.
• If there is continued pain the patient should immediately seek an appointment with their GP or surgeon for advice.
• Note – Lasers are a powerful energy source and the patient and the medical attendees will wear eye protection during the procedure.
• In a small number of cases the varicose veins can return and  EVLT or other types of varicose vein removal can be deployed.

What is the cost of Endo – Venous Laser Treatment

The costs vary depending on the severity of the condition and a number of other factors including the experience and cost of the surgeon and his team.

What are the risks?

All medical procedures carry some risk. With Endo Venous Laser Therapy the risk is reported to be very small. Some of the post operative risks include :-

• Bruising
• The vein may not be fully closed.
• Tenderness in the treated area
• Some temporary numbing of the limb.
• Hematoma
• Thrombophlebitis
• Infection

It is advisable to discuss and understand all of the risks associated with Endo Vascular Laser Therapy with your GP/Surgeon/Physician before undergoing any treatment.

Success Rates for EVLT

The success rate for Endo – Venous Laser Therapy are very good, as high as 90% with the pain and recovery time associated with older treatments for varicose veins being long forgotten.

As the procedure is carried out as an outpatient recovery time is generally faster than procedures carried out under general anaesthetic.

What should I ask my doctor?

Prior to taking any surgical or medical procedure you must discuss all of the options and understand what is being proposed, the particular procedure to be used and be sure of the Physician/Doctor/Surgeon who is going to be carrying it out.

There are a number of questions you must ask during your consultation process, including :-

• What is the cause behind my condition?
• Are there any tests you would recommend be undertaken first?
• What are the alternative procedures for treatment?
• Will my existing health conditions restrict my options for treatment?
• Do I need to change my lifestyle?
• Should I be seeing specialist?
• What can you provide as additional information?
• How often have you carried out Endo – Venous Laser Therapy and what has been your success rate?
• What are the risks and how are they mitigated?

Do not hesitate to ask ANY question that you want to get an answer for to assure you that you understand everything about the proposed treatment.

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Sclerotherapy — Spider Vein Treatment
Causes of Varicose Veins
Laser Vein Removal to remove varicose veins
Varicose Vein Treatment In Houston, Texas

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