Endovenous laser therapy (EVLT) for varicose veins: how does it work?

EVLT has emerged as the gold standard for treating the primary veins associated with varicose vein development, supplanting older, less effective surgical techniques like vein stripping. Unlike surgical methods, EVLT is swift and straightforward, conducted under local anaesthesia without the need for hospitalisation or general anaesthesia.

Here to explain more about the procedure is leading minimally invasive venous surgeon Mr Alastair Lewis.

Endovenous laser therapy (EVLT) is:

• Swift: Typically lasting between 30 to 45 minutes.
• Convenient: No prolonged hospital stays are necessary, with normal activities resuming immediately.
• Effective: Success rates exceeding 95%, often with immediate symptom relief.
• Minimally Invasive: No surgical incisions are required.

EVLT treatment procedure:

All EVLT procedures are outpatient, walk-in, walk-out affairs. With ultrasound guidance, a small cannula is inserted into the target vein, and a thin laser fibre is threaded inside, gently heating and destroying the vein wall. Local anaesthesia numbs the area, and any visible varicose veins are usually treated simultaneously with foam injections. Patients can resume normal activities right after treatment, though compression stockings and mobility are recommended for 1 to 2 weeks.

Suitable veins for EVLT:

EVLT targets the deeper main veins in the leg, which cause visible varicose veins. However, it's not suitable for superficial veins or tortuous veins close to the skin. Typically, a combination of EVLT and foam sclerotherapy achieves the best cosmetic outcome.

Unsuitable veins for EVLT:

Veins close to the skin or those with tortuous paths aren't suitable for EVLT and are usually treated with foam sclerotherapy instead.

Comparison with radiofrequency ablation (RFA):

While RFA is simpler, EVLT is preferred by experienced practitioners for its versatility and fine-tuning capabilities, akin to professional photographers opting for more complex cameras. If your specialist can't perform EVLT, they may not offer the full range of modern varicose vein treatments.

If you would like to book a consultation with Mr Lewis, do not hesitate to do so by visiting his Top Doctors profile today.