Colchester Veins

21st century treatment for varicose veins
Home     Varicose Veins     Thread Veins     Profile     FAQs     Contact us     Calendar      
Treatment
Surgery
Laser Treatment
Radiofrequency
Sclerotherapy

Endovenous Laser Treatment (EVLT or EVLA)

Results of Laser Treatment

In this type of treatment a laser fibre is passed into the defective vein and laser energy used to block it off. Usually the defective superficial vein trunk treated is either the long saphenous or short vein which runs down the inside of the thigh and down the back of the calf respectively. The procedure is usually performed under local anaesthetic as a day case. About 70% of varicose veins that have not been operated upon  and 20% of previously treated varicose veins are suitable for laser treatment. Veins unsuitable for EVLT may be too tortuous or may be partially blocked by thrombophlebitis thereby not allowing the laser fibre to be passed up the vein. Preoperative ultrasound scanning will identify which veins are suitable.


In most cases treatment of the main vein trunk is sufficient. However, in some cases additional treatment of the lumpy veins (varicosities) is necessary either by sclerotherapy or phlebectomies.


The advantages of laser treatment over surgery are less pain, quicker recovery, less bruising and less scarring. It can be done under local anaesthetic.


The disadvantages are that the long term recurrence rate is not known and further treatment of residual lumpy veins (varicosities) may be required.


The Procedure


Prior to the procedure the surgeon will obtain consent and mark the vein with a permanent marker with the aid of an ultrasound scanner (see left).



After cleaning the skin with antiseptic solution, local anaesthetic is injected to freeze the skin. A small puncture wound measuring a few mm is made and a needle is introduced into the defective vein with the aid of the ultrasound machine (see below).



A fine wire guide is passed up into the vein and a fine tube (catheter) passed over the wire, the laser fibre is threaded through this.



The laser fibre is carefully positioned a safe distance from the deep vein using ultrasound guidance. A dilute local anaesthetic solution is injected around to protect the tissues from the heat of the laser. Several injections up the leg may be required and can make the leg feel swollen.  Laser goggles are worn by everyone in the operating theatre, including the patient, to protect the eyes from laser energy before the laser is switched on. The laser fibre is gradually pulled back and the defective vein treated. A Compression bandage is applied after removal of the laser fibre.  The procedure usually takes between 30 to 45mins.


After the procedure

Tightness along the path of the treated vein is common and simple painkillers should be taken to reduce symptoms. Bandages should be removed in 1-2 days and replaced by compression stockings which need to be worn for up to two weeks. The patient is advised to walk and resume normal activities within a couple of days. Heavy exercise and gym workouts should be avoided in the first week. The patient is reviewed in six weeks, by then most of the varicose veins would have shrunk and many disappeared. Over 70% of patients do not require further treatment. Remaining veins can be treated by injection sclerotherapy.




Side effects


Bruising and acheing along the path of the vein treated are common. Rarer side effects are heat damage to the skin causing redness of the overlying skin, a patch of skin numbness in the lower leg and deep vein thrombosis (DVT). In a small number of cases the treatment doesn’t work and the vein fails to block off. The treatment can be repeated or alternative treatment performed. Varicose veins can come back as with any form of treatment.