Endovenous Laser Treatment is the treatment of choice in many patients with varicose veins.

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.

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

You must make sure that you keep yourself well-hydrated, by drinking plenty of fluid (at least 2 litres) in the 24 hours prior to treatment.

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

DO NOT FORGET YOUR STOCKINGS.

The operation

The procedure aims to close down the saphenous vein, the vein responsible for the varicose veins.

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The laser is then activated, and the laser probe slowly withdrawn causing a thermal injury to the entire length of the saphenous vein.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).

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.

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 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 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, 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 risk of Deep Venous Thrombosis, but this is low (less than 0.1%).

NOTE: If you have any concerns, phone Northwestern vascular immediately