Endovenous Laser Therapy (EVLT)
Quick and minimally invasive, endovenous laser therapy is an alternative to traditional vein stripping. This treatment leaves only a single small scar at the insertion site, roughly one-quarter inch or less. The procedure is performed under local anesthesia – with or without sedation – in our office. The recovery time after EVLT is also shortened when compared to other treatments and is relatively pain free. Prior to treatment, a physical examination is performed by your surgeon and an ultrasound study of the veins in your legs will be scheduled for a later date. Based on the results of these studies, your surgeon may recommend you have the endovenous laser therapy procedure. Although published reports and clinical experience to date show this to be an effective procedure with fewer complications than other options, the long term closure rate of the saphenous vein is not known. The closure rates for one year or less are above 95%.
The benefits of endovenous laser therapy for varicose veins include…
- Performed under local anesthetic, with or without oral sedation, in the office
- No IV, hospital stay, or recovery room time
- Minimally invasive, resulting in a very small risk of infection, blood loss, noticeable scars, or other significant problems
- Less than 1 hour treatment time
- Rapid recovery
- Normal daily activities are encouraged immediately after having EVLT
- You can return to work without using valuable paid time off for most occupations
- Excellent clinical and aesthetic results
- Minimal pain compared to outdated and more invasive treatments
- More cost effective than traditional treatments
What are the risks of the EVLT procedure?
Only minimal complications have been experienced with the endovenous laser procedure, however, there are potential risks with any medical procedure. Potential risks include: vessel perforation, deep vein thrombosis, pulmonary embolism, phlebitis, hematoma, infection, scarring, nerve injury, parasthesia, skin burns, post-phlebitic syndrome resulting in permanent swelling of the leg, severe allergic reaction, and the remote possibility of death.
What happens during the EVLT procedure?
The treatment itself usually takes about an hour. First, with the patient’s consent, photographs may be taken of the veins in the leg for insurance, education, and marketing purposes. The area to be treated is then marked using ultrasound and anesthetized using a local anesthetic. The leg is washed with a solution to kill any germs on the skin and sterile drapes are applied. Ultrasound is used throughout the procedure to locate the vein to be treated and to assure proper placement of the laser fiber at all times.
The laser fiber is placed through a very small incision about one eighth of an inch long near the inside of the knee. The tissue around the vein is then injected with a solution that both numbs and protects the surrounding tissues from the heat of the laser. The surgeon slowly pulls the fiber backwards through the vein while the laser energy is applied in short pulses. This causes the vein to shrink, collapse, and seal shut. Once it is sealed, the healthy veins take over and redirect blood flow back to the heart. A small adhesive strip is placed over the tiny incision to keep it closed as it heals. No stitches are needed. Absorbent pads are then placed over the injection sites as well as the incision to absorb any of the injected fluid. Compression hose are placed over this and will need to be worn for 48 hours uninterrupted, then for two weeks while awake and on your feet.
Is endovenous laser therapy covered by my insurance?
Insurance coverage for the procedure is determined on a case-by-case basis. In most cases, insurance companies decide whether or not to cover treatment based on medical necessity. If you have concerns regarding coverage for this procedure, we recommend you call your insurance company to discuss their criteria for coverage, as every company is slightly different. You should also ask about coverage for compression hose that will be required after the procedure.
How successful is EVLT?
Early results have been extremely favorable. Success rates have been as high as those for the conventional surgical approach which is considered the “gold standard” treatment. EVLT generally treats most varicose veins successfully but additional therapy is needed in some cases.