Endovenous laser treatment

Endovenous laser treatment (EVLT), also known as endovenous laser ablation (EVLA), is a minimally invasive procedure used in the treatment of varicose veins. It involves the use of laser energy to cause thermal damage to the vein wall, resulting in fibrosis and eventual closure of the vein. This technique has gained popularity due to its effectiveness, minimal discomfort, and quick recovery time compared to traditional surgical methods such as vein stripping.

Overview

Endovenous laser treatment is primarily indicated for the treatment of saphenous vein reflux, a condition that contributes to varicose veins and chronic venous insufficiency. The procedure is performed under ultrasound guidance, which allows the physician to visualize the vein and ensure precise delivery of laser energy. A thin laser fiber is inserted into the vein through a small puncture in the skin. The laser is then activated as the fiber is slowly withdrawn, heating the vein and causing it to collapse and seal shut.

Procedure

The EVLT procedure typically follows these steps:

1. The treatment area is numbed using a local anesthetic.
2. Under ultrasound guidance, a catheter or sheath is inserted into the vein through a small incision.
3. A laser fiber is threaded through the catheter and positioned at the correct location within the vein.
4. Laser energy is applied as the fiber is slowly withdrawn, causing the vein to heat, collapse, and seal shut.
5. The small incision is covered with a bandage; no stitches are usually required.

Advantages

Endovenous laser treatment offers several advantages over traditional surgical treatments for varicose veins, including:

• Minimally invasive with minimal scarring
• Performed under local anesthesia, reducing risks associated with general anesthesia
• Short procedure time, typically under an hour
• Rapid recovery, with most patients able to resume normal activities the same day
• High success rate and low recurrence rate

Risks and Complications

While EVLT is generally safe, as with any medical procedure, there are potential risks and complications, including:

• Bruising and swelling at the treatment site
• Temporary numbness or tingling
• Infection at the puncture site
• Deep vein thrombosis (DVT)
• Phlebitis (inflammation of the vein)
• Skin burns or nerve damage (rare)

Aftercare

Post-procedure care for endovenous laser treatment is straightforward. Patients are typically advised to:

• Wear compression stockings for a specified period to support vein closure
• Avoid prolonged standing or sitting to encourage blood flow
• Engage in light walking to promote circulation
• Attend follow-up appointments for ultrasound examinations to ensure the treated vein remains closed

Conclusion

Endovenous laser treatment represents a significant advancement in the management of varicose veins, offering a less invasive alternative to traditional surgery with a quick recovery time and high patient satisfaction. As with any medical procedure, patients should consult with a qualified healthcare provider to determine if EVLT is the appropriate treatment for their condition.