EVLT (Endovenous Laser Treatment)

EVLT or Endovenous Laser Treatment is a relatively new procedure for the treatment of valvular reflux (leaky valves) in the groin and is the newest and most promising weapon in the phlebologist's treatment arsenal. It is performed as an outpatient procedure under local anesthesia and is associated with minimal if any discomfort. As with the other treatment modalities for saphenous reflux disease, this procedure is only to treat the valvular problem and does not treat the visible varicose veins of the leg. Though the pressure in the varicose veins will lessen, the remaining varicose veins will, most likely, still need to be treated by either compression sclerotherapy or ambulatory phlebectomy.

The EVLT and Closure procedures are very similar in their preparation though the EVLT requires less time to perform. The most significant advantages of EVLT are little to no risk of DVT (blood clots) or skin burns.

The actual procedure involves the identification and marking of the greater saphenous vein (the major surface vein where the valve is leaking) by ultrasound. A small sheath is placed through the skin by the knee and a laser fiber is introduced. The laser is then positioned at the level of the bad valve with proper positioning of the laser tip confirmed by ultrasound. The laser is then activated and withdrawn. Once the sheath and laser are removed, compressive dressings are applied with a gradient compression support stocking over the top of the dressings. The stocking and dressings may be removed in 24 hours but the stocking must then be worn for another two weeks during periods the patient is up on their feet. The leg is re-checked after the two week period and the varicose veins are re-assessed. If any further treatment is necessary, it will be discussed at that time.

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