Endovenous Laser Therapy (EVLT) is the treatment of choice for many patients with varicose veins

Day Before Procedure

You must make sure that you keep yourself well-hydrated, by drinking plenty of fluid (at least 2 litres) during the course of the day.

Day of Procedure

No fasting is required.

You will be required to not drive for 24 hours after procedure.

Remember to wear loose comfortable clothing.

The procedure will take approximately one hour.

DO NOT FORGET YOUR STOCKINGS.

The Procedure

Clexane (an anti-coagulant) will be administered. The procedure will take approximately one hour and patients will need to be driven home after the procedure.

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 junction, in preparation for treatment. Local anaesthetic is administered around the saphenous vein, to protect the surrounding structures, and so you won’t feel any pain with the laser. Some find the administration of local anaesthetic a little uncomfortable.

The laser is then activated, and the laser probe slowly withdrawn causing a thermal injury to the entire length of the saphenous vein.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

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

Most of the varicose veins will shrink as a result of Endovenous Laser Treatment (EVLT) and will not require any further treatment. However, in 20 – 30%, follow-up sclerotherapy is required to obliterate any residual veins. This is performed 6 to 8 weeks later, using ultrasound guidance.

Post-procedure course

Patients are encouraged to be as active as possible, within their comfort zone with at least 40 minutes of walking each day. Simple analgesics or anti-inflammatories such as Paracaetamol and Nurofen may ease any discomfort.

Brusing along the inner thigh is very common and generally subsides within 2 weeks.

You must wear the compression stocking day and night for the first week, and then during the day for the second week (remove for showering).

A follow-up ultrasound scan will be performed 1-2 weeks following the procedure.

If some of the varicose veins have not responded, DO NOT WORRY as they can 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 minor risk of Deep Venous Thrombosis, but this is low (less than 0.1%).

NOTE: If you have any concerns, phone North Western Vascular immediately