Laser treatment for varicose veins

What is endovenous laser varicose vein surgery (EVLT)?

Endovenous laser varicose vein surgery or EVLT (Endovenous venous laser treatment) is a procedure that employs heat from a laser to reduce varicose veins. A laser is a device that sends a thin beam of radiation in the form of light. Laser energy is used to heat the vein in order to destroy it.

Laser surgery closes and shrinks the varicose vein and causes scar tissue within the vessel. This seals off the vein. Blood then flows through other nearby veins instead. Laser surgery if your varicose veins are sore, or red and swollen (inflamed). Laser surgery may also be recommended if the skin over your varicose veins is irritated. Varicose veins are not usually a serious health problem, but they can be painful. You may also not like how they look.

What is done in this procedure?

Generally, endovenous laser varicose vein surgery follows this process:
A small cut or incision will be made in the skin and a fine tube or catheter is guided up the affected saphenous varicose vein. A laser fiber will be put into the catheter. As the catheter is slowly pulled out of the vein, the laser will heat up the length of the vein. The vein will close up and should eventually shrink so that no blood can flow through it. The procedure can be done under general or local anaesthetic.

A fine tube (catheter) is passed through the skin near the knee and then threaded. A laser fiber is then introduced through the catheter and the tip of this fiber emits heat that seals the walls of the vein

This procedure doesn’t require a hospital stay. It may be done in your healthcare provider’s office. The procedure usually takes less than an hour. You can likely go home the same day. Bring loose-fitting clothing to wear right after your surgery.

How is laser vein surgery different to standard surgery?

Standard surgery usually requires a cut in the groin to tie off the vein, after which it is removed by a stripping device. This can cause significant bruising pain following treatment. EVLT avoids the need for a cut in the groin and there is minimal bruising so people who have EVLT can usually return to normal activity sooner than those who have standard treatment.

What are the risks of endovenous laser varicose vein surgery?

All surgeries have some risks. Some possible risks of EVLT or laser varicose vein surgery include:

• Infection
• Pain over the vein
• Bleeding
• Bruising
• Nerve damage
• Redness or swelling (inflammation) of the vein
• Blood clots
• Changes in skin color over the treated vein
• Burns

You may have other risks, depending on your general health. Be sure to talk with your surgeon about any concerns you have before your surgery.

How do I get ready for endovenous laser varicose vein surgery?

• Ask your surgeon any questions you have about the procedure.
• You will be asked questions about your health history. You might have a physical exam to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests.
• The healthcare provider needs to be told if you have a history of bleeding disorders and if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.
• Sensitivity or allergy to any medicines, latex, tape, contrast dyes, and anaesthesia medicines (local and general) should be conveyed.
• Tell your healthcare provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.
• You might be advised not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight. Your healthcare provider may have other instructions for you.

What happens after endovenous laser varicose vein surgery?

After EVLT:

• You will be encouraged to walk right after the procedure, for about 30 to 60 minutes.
• Your leg may have some bruising. The bruises should go away in about 2 weeks.
• You’ll need to have someone drive you home after your surgery.

What should be the postoperative care to be taken after the endovenous laser varicose vein surgery?

After you go home, be sure to follow any instructions from your provider. You may be told to:

• After you go home, be sure to follow any instructions from your provider. You may be told to:
• Check the incision sites every day. It’s normal to see light pink fluid on the bandage.
• You may need to take a sponge bath until the bandages are removed.
• Wear compression stockings for a few days or weeks, if advised. These stockings gently squeeze your legs. This helps to prevent swelling in your legs. It can also help stop your blood from clotting or pooling.
• Not sit or lie down for long periods of time. Keep your leg raised when sitting.
• Not stand for long periods of time.
• Walk about 3 times a day for 10 to 20 minutes each time. Do this for 1 to 2 weeks.
• Keep active, but don’t run, jump, or lift heavy things for 1 to 2 weeks.
• Not take hot baths for 1 to 2 weeks.

When it comes to medicine, be sure to:

• Take medicines as advised.
• Ask your healthcare provider when it will be safe to take blood-thinning medicine again, if you stopped taking it for the surgery

Call your healthcare provider if you have:

• Signs of infection in the treated area. These include redness, warmth, or fluid leaking from the incision.
• Swelling that gets worse, or new swelling
• Any pain that keeps you from doing your normal activities

Your healthcare provider may give you other instructions, depending on your situation.