1) What is EVLT and how does it work?
EVLT stands for Endovenous Laser Treatment which happens to be one of the latest and most advanced technique in treating varicose veins successful. It is a minimally invasive procedure which works on the principle of using laser energy to seal the veins shut from within. During the procedure, a tiny is puncture is made in the skin through which a catheter containing a laser fiber is interested into the vein under ultrasound guidance. Local anaesthesia is administered both around and along the vein to minimize pain. The laser is activated as the optical fiber and catheter are carefully withdrawn simultaneously, leading to the obliteration of the vessel lumen. The vein collapses and blood no longer flows through it, thus resolving the varicosity.
2) Am I a good candidate for this procedure?
You would make a good candidate if you are experiencing the following –
a) painful varicose veins
b) discomfort, heaviness or cramps in the legs
c) swelling and discolouration of the limb
d) eczema of surrounding skin and development of non – healing ulcers due to chronic venous insufficiency
e) rupture and extensive bleeding from the engorged veins
f) unacceptable cosmetic disfigurement
3) Will the loss of a vein cause any problems?
Varicosity develops in the superficial veins of the legs. Upon it’s closure using laser energy, blood is diverted to other normal veins in the legs, namely the deep veins. This results in improved circulation, alleviation of symptoms and better aesthetics. So no, problems are unlikely to arise as the body compensates for the lost vein quite efficiently.
4) How long will the procedure take and how many sittings do I need?
Here at AVIS Vascular Center, the procedure is streamlined and takes about 20-30 mins. Only a single sitting is needed.
5) How long will I take to recover?
EVLT is carried out on an outpatient basis and most patients resume normal activity soon after the procedure. However, it is advisable to rest the limb for a few minutes.
6) What are the possible side effects/ complications that I might face?
This procedure is considered extremely safe but
even the most minimally invasive procedures come with a certain degree of risk. There are chances of developing a small amount of bruising which disappears within a few days. Delayed tightness or pulling sensation in the treated area is known to occur 4-7 days after the session and is considered normal. It soon subsides. Other complications include –
- Blood clots
- Redness, swelling, pain over the vein due to inflammation2
- Change in the colour of skin over the treated area
- Accidental laser burns
These maybe enhanced if you suffer from co-morbidities like diabetes, hypertension and other chronic conditions or poor health in general. These potential risks are to be weighed against the complications you are likely to develop if your varicose veins remain untreated. Consult your surgeon who will address your concerns and provide you with further information regarding this.
7) Will there be any pain during/ after the procedure? What about scarring?
It is virtually a painless procedure done under local anaesthesia. Mild, tolerable pain is to be expected once the effect of the anaesthesia wears off. Like most minimally invasive procedures, scarring is negligible. Puncture wound created during the insertion of catheter is minute and heals well with minimal scarring.
8) Is general anesthesia needed?
No. General anaesthesia, which is needed for the traditional surgical method of ligation and stripping of the vein is not required for this procedure. It is performed under local anaesthesia which is safe and effective.
9) I’ve heard so much about laser being harmful. Is it safe to use on my body?
Since the laser energy is targeted directly towards the affected vein, damage to any other part of the body is highly unlikely. However, as a precautionary measure, you will be given special goggles to protect your eyes, just incase any accidental firing of the laser occurs outside the body.
10) Is the cure for my condition guaranteed with this procedure? Are there any chances of recurrence?
Research data based on 5 years follow up studies suggests that EVLT has a success rate of nearly 98%, which is much higher than other alternatives like sclerotherapy, radiofrequency ablation, ambulatory phlebectomy or the surgical option of vein stripping. Hence, it is the preferred choice among surgeons these days and has risen to the level of being considered the “gold standard” when it comes to treatment of varicose veins.
There is close to zero chance of recurrence in a vein which is successfully treated using EVLT. However, if varicose veins are noticed again, it is most likely due to other sources of reflux rather than the treated vein. Such recurrence rates are around 10%.