Endovenous laser treatment (EVLT) . . .

If you have varicose veins then one of the causes is usually an incompetent long saphenous vein, which travels on the inside of the leg from the ankle to the groin. If blood is allowed to flow backwards along the vein due to the effect of gravity and faulty valves, varicose veins will form along its branches, especially below the knee. Experience has shown that it is important to remove the saphenous vein prior to treatment of the more superficial varicose veins to reduce the chance of them promptly coming back.

Standard surgery frequently requires a cut in the groin to disconnect the long saphenous vein from the deep vein and then remove it by a stripping device. This procedure results in extensive swelling, bruising and pain after the operation and requires a general anaesthetic. There is a risk of deep vein thrombosis due to the trauma and the patient's inability to ambulate after the procedure. Occasionally a patient will get a hematoma or an infection in the groin wound (about one patient in every hundred).

Dr. Min in New York City developed the EVLT procedure and shortly after it was approved in Canada in 2002, The Vein & Laser Clinic introduced it in British Columbia. To date, several hundred patients have undergone the procedure in the clinic. The technique uses laser energy delivered through a laser fiber inserted into the saphenous vein to seal the vein shut. No cut in the groin is needed and the operation can be performed completely under local anaesthetic. It allows closure the thigh vein without stripping it from the body. The end result is the elimination of the backflow of blood in the vein with resultant reduction of venous pressure in the distal tributaries. The latter can then be treated with micro-incisions, compression sclerotherapy or a combination of both.

Patients who have undergone EVLT can usually return to normal activities much sooner than those who have had the conventional treatment. The adverse events after EVLT have been relatively few. Occasionally patients get some redness in the skin of the thigh and some residual but transient post-inflammatory hyperpigmentation has been noted in the treatment area. Immediately after the operation the vein in the thigh can be felt through the skin like a tender 'cord'. This goes away over the course of a few weeks as the inflammation settles down. Rarely, some patients get a feeling of numbness or altered sensation over the vein. Again, this usually settles over a few weeks.

In rare cases, EVLT cannot be successfully performed. This is usually because the varicose vein is very tortuous and the guidewire will not pass through the affected vein segment and up to the groin. In such cases, the veins    can be treated by standard surgery or the long saphenous section/sclerotherapy technique.

Laser fiber is passed up into vein to proximal point of reflux (usually to the sapheno-femoral junction in the groin). The laser is turned on and fiber is slowly withdrawn, causing the vein to collapse and close behind it.

Please click here to view an informative video