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What is EVL T?

Endovenous Laser Therapy (EVL T) is a new technique for the treatment of varicose veins. The technique has been developed over the last four years.

How does it work?

A laser fibre is inserted into the vein and the vein is destroyed by laser energy "heating" the inside of the vein. The procedure is performed through a tiny cut at the knee level, usually only 1-2mm long. The procedure is performed with local anaesthetic.

What are the advantages?

No general anaesthesia is required.

No cut is required at the groin.

The procedure is less painful than surgery.

Time to return to normal activity is much quicker than surgery, typically 1-2 days.

What are the disadvantages?

Some patients treated with EVL T will require further treatment for their varicose veins in the form of injection sclerotherapy. This is an outpatient procedure.

Who is suitable?

Any patient with varicose veins due to reflux in the long saphenous vein in the thigh, or its major branches is likely to be suitable. This amounts to 70-80% patients with varicose veins.

Who is not suitable?

Not all patients with varicose veins are suitable. The procedure is not recommended for people who are unable to walk; in poor general health; have a clotting-disorder or are pregnant. Pre-procedure ultrasound scanning might reveal that your varicose veins are not suitable for EVLT. Most often this is because the vein is excessively twisting or superficial thrombophlebitis (inflammation of the vein) is found.

What are the results of this treatment?

The early results of this treatment are extremely good. Up to two years of follow- up has shown over nine out of ten patients treated have a good result and would recommend it to others. As the procedure is new, the longer-term results are not known. There are no indications so far, that EVL T is inferior to traditional varicose vein surgery.

What are the side effects?

Common side effects are bruising and ache or pain in the course of the treated vein. Generally, these side effects are considerably milder than for surgical stripping.

Rare side effects are skin discolouration or thermal injury to neighbouring tissues that might cause skin erythema (reddening) or neuropraxia ('pins and needles' sensation) in the leg, which recovers over time.

There is a possible risk of infection of the leg or deep vein thrombosis (DVT) - or clot formation in the major veins of the leg. The actual incidence of these problems is extremely rare.

What can I expect after the treatment?

At the end of the laser treatment your surgeon will apply a compression bandage to you leg. This should be worn for seven days. Immediately after the procedure, you will be asked to take a 20-minute walk within the hospital. After this you will be checked out and allowed home.

You should resume normal activity as soon as possible. This is normally within one or two days. Hot baths and vigorous activity such as gym workouts should be avoided in the first week. You will be given a short course of painkillers to reduce any post treatment discomfort.

What follow-up is required?

A follow-up appointment four to six weeks after your treatment will be made for you. At this follow-up, the success of the treatment will be checked and we will discuss with you whether any additional treatment might be useful. After this you will have further outpatient appointments at six months and one year, depending on your circumstances.