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By Dr Sibasankar Dalai
Sr. Consultant Neuro Vascular Intervention
EVLT Procedure Benefits Risks Care at Medicover Frequently Asked Questions

EVLT

EVLT (Endovenous laser therapy), also known as endovenous laser ablation, is a procedure that uses heat from a laser to reduce varicose veins. Varicose veins are swollen and enlarged ones, most common in the legs. Varicose veins can form when the valves in your veins are damaged, which interferes with blood flow. Too much blood accumulates in the veins over time. Under your skin, the veins may bulge, twist, and protrude. They can also cause leg pain, cramping, or swelling.

A laser is a device that sends a beam of radiation in the form of light. It closes and shrinks the varicose vein, leading to scar tissue formation within the vessel. This closes off the vein, and then the blood flows through other nearby veins.

Procedure

Before the procedure

  • Your doctor will take your medical history and perform a physical examination to ensure that you are in good health before undergoing the procedure.
  • It would help if you also had blood tests and other diagnostic tests such as ultrasound of veins.
  • Photographs of the problematic area are taken for before and after comparisons.
  • Inform the doctor if you have a history of bleeding disorders and are taking blood-thinning medications such as aspirin, ibuprofen, or other drugs that affect blood clotting. You may need to stop taking these medicines 5-7 days before the surgery. This is so that the blood thinner gets cleared from the body, and you won’t have to face significant bruising and other complications.
  • Inform your doctor if you are sensitive to or allergic to any medications, latex, tape, contrast dyes, or anesthetic medications.
  • Inform the doctor about all of the medications that you are taking. This includes both OTC and prescription medications, vitamins, herbs, and other supplements are also included.
  • It would help if you started fasting for 8 hours before the procedure. This frequently involves no food or drink after midnight.

During the Procedure

  • You should lie down in a hospital bed.
  • The procedure is guided by an imaging method such as ultrasound.
  • Anesthesia is injected into the leg to be treated.
  • After your leg has become numb, a needle is used to make a small hole (puncture) in the vein to be treated.
  • A catheter with a laser heat source is inserted into your vein.
  • When the catheter is in the proper position, it is gradually drawn backward. The vein is sealed off as the catheter emits heat.
  • Other side branch varicose veins may be removed or tied off through several small incisions in some cases.
  • When the treatment is completed, the catheter is removed. Pressure is applied to the insertion site to stop any bleeding. Your leg will then be covered by an elastic compression stocking or bandage.

After the procedure

  • No stitches are required.
  • You should consider taking anti-inflammatory medication for 5-7 days.
  • Typically, patients should elevate the treated limb when not moving, keep the incisions clean and dry, avoid swimming or hot tub baths.
  • A compression pad is placed over the treatment area, and a thigh-high support stocking is placed on your leg. After three days, you can remove the compression pad. The support stocking should be worn for at least a week.
  • You are encouraged to walk for at least 20 minutes three times per day following the procedure. You should, however, avoid strenuous physical activity and heavy lifting during that week.
  • Most patients can manage their pain with over-the-counter painkillers. Bruising in and around the treated area is also common. Bruising and discomfort usually go away quickly.
  • In follow-up appointments, doctors will perform color duplex ultrasound one week after the procedure and at various monthly intervals to confirm success.

Benefits

  • Effective at eliminating painful symptoms
  • Faster recovery and you can resume your daily activities immediately following treatment.
  • Outpatient procedure.
  • No scarring or stitches.
  • No hospitalization.
  • Decreases your risk of DVT.
  • Offers up to a 98% success rate.

Risks

Care at Medicover

Get the best varicose veins treatment by surgeons at Medicover Hospital. Laser surgery is preferred as the treatment for varicose veins because of its smaller risk and faster recovery. The team of doctors and specialists include renowned vascular surgeons and interdisciplinary trained interventional radiologists with an international level of experience to treat varicose veins. From academic recognition to proven clinical experience, radiologists and vascular surgeons are peer-recognized for their qualifications, and constantly committed to patient-centric care. Medicover Hospitals offer an unparalleled range of holistic healthcare services for patients.

Citations

https://www.northwell.edu/cardiovascular-thoracic-services/vascular-surgery/treatments/endovenous-laser-therapy
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/endovenous-laser-varicose-vein-surgery
https://www.cedars-sinai.org/health-library/tests-and-procedures/e/endovenous-laser-varicose-vein-surgery.html
https://blog.radiology.virginia.edu/endovenous-laser-ablation-therapy-evlt/
https://www.usaveinclinics.com/treatments/varicose-vein-treatment/endovenous-laser-treatment/

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Frequently Asked Questions

1. What are varicose veins?

Varicose veins are blue, red, or flesh-colored enlarged veins. They frequently resemble cords and appear twisted and bulging. They can swell and rise above the skin surface. Varicose veins are commonly found on the calves, thighs or back side of the leg. They can also form around the vagina and buttocks during pregnancy.

2. Are varicose veins hereditary?

More than 80% of varicose vein cases are caused by heredity reasons. Other factors include pregnancy, obesity, hormonal therapy, prolonged standing or sitting, and injury.

3. Is EVLT painful?

No, patients report no pain while the vein is being lasered. There may be some discomfort when the local anesthetic is administered. There may be some discomfort and tenderness in the treated area for 1 to 2 weeks after the procedure.

4. Will the loss of the vein cause any complications?

Varicose veins mostly develop in the superficial veins of legs. After it is closed with laser therapy, blood is diverted to other normal veins in the legs, specifically the deep veins. This results in improved circulation, symptom relief, and improved aesthetics. So, no, problems are unlikely because the body compensates for the lost vein very efficiently.

5. Is laser therapy safe for treating varicose veins?

The laser energy is directed directly at the affected vein, and it is rare that any other part of the body will be harmed. As a precaution, you will be given special goggles to protect your eyes in case the laser accidentally fires outside the body.

6. Will my varicose veins return after the EVLT procedure?

This used to be very common with the old 'high tie and strip' operation, with up to 30% of patients experiencing a significant recurrence following surgery. The risk of recurrence after laser surgery is about 1%. However, there is a 10% chance that another vein on the same or other leg will become varicose over the next few decades. However, for the vast majority of people, EVLT eliminates varicose veins.