ELVT The venous system of the lower extremities consists of the superficial system (e.g., hospital long and short saphenous veins and saphenous tributaries) and the deep system (e.g., popliteal and femoral veins). These two parallel systems are interconnected via perforator veins and at the saphenofemoral and the saphenopopliteal junctions.
Endovenous Laser Therapy is a treatment for varicose veins in which a laser optical fibre is inserted under ultrasound guidance into the great saphenous vein (GSV) or small saphenous vein (SSV) through a small puncture. The laser is activated as the laser fibre is slowly withdrawn resulting in obliteration of the vein along its entire length. The treatment, which is performed without sedation, but using local anaesthesia usually takes between 1 and 2 hours and the patient walks out under his or her own power. The leg is bandaged and/or placed in a stocking that the patient wears for up to 3 weeks afterwards.
The ELVT Procedure
The ELVT procedure will start with an ultrasound of the affected area to highlight the position of the vein to be treated. Being a fairly non-invasive procedure only a local anaesthetic is used to numb the surrounding skin above the vein to be treated.
In the next stage a needle is inserted in to the vein and an optical fibre is passed up the vein towards the groin whilst it’s positioning is checked using ultrasound scans. Once the laser is turned on, sometimes more local anaesthetic is provided to alleviate any discomfort. After the laser is turned on the fibre is slowly withdrawn along the offending vein and seals up the vein from the inside.
After successfully treating the vein with EVL, larger veins will have to be removed to prevent thrombophlebitis (a condition that causes the vein become very hard, red and tender when the blood stops flowing, even if still inside a vein or artery, it will clot.) This procedure is called a Phlebectomy. This is achieved through tiny incisions for the best cosmetic outcome.
After the vein has been sealed the laser fibre is withdrawn and the treated area is bound in bandages which should be worn for 7 days post procedure. You should be provided with a support stocking to wear for up to 4 weeks post treatment and are encouraged to walk as much as possible throughout this recovery period.
Over the following days the patient may experience some bruising and discomfort around the area of treatment which can be addressed with over the counter pain killers and wearing the compression bandage provided. It is also recommended that contact sports, swimming and the gym should be avoided for 3-4 weeks after treatment. Finally patients will be required to meet with the physician at 3 and 6 weeks post treatment to ensure that the treatment was a success and address any concerns or problems that may occur.
Risks and Complications of EVLT
The risk of complications occurring in EVLT treatment is very small. Firstly there is a 3% chance that the vein will not be completely eliminated and around 5% of patients will experience excessive tenderness and bruising around the treated area. Finally around 3% of patients may experience a numbing sensation following EVLT in their lower leg however this will only last a few months before sensation is restored.
This is a new treatment available from Refresh Southwest that is No Longer available on the NHS
Plymouth, Exeter, Devon and Cornwall.