What is Endovenous Laser Treatment for Varicose Veins?

Endovenous laser treatment is a procedure that uses laser heat to treat varicose veins.

Varicose veins most often appear in the legs. Varicose veins can develop when the valves in your veins are damaged. This leads to blood circulation problems. Over time, too much blood pools in the veins. The veins can swell, twist, and bulge beneath the skin. They can also cause symptoms such as pain, cramping, or swelling in the legs.

During endovenous laser varicose vein therapy, heat from a laser is delivered into the vein through a thin, flexible tube called a catheter. This closes off blood flow in the main vein affected by this problem.

 

Endovenous Laser Treatment for Varicose Veins Procedure

How to Prepare for Endovenous Laser Varicose Vein Treatment

To minimize complications or risks, you must prepare for your endovenous laser procedure to treat varicose veins by following your healthcare provider's instructions.

First, tell your doctor if:

• You are pregnant or think you might be;
• You are breastfeeding;
• You smoke or regularly consume alcohol;
• You have other health problems, such as diabetes or kidney problems;

Tell your healthcare provider about all the medications you are taking. You may need to stop taking some or all of them before the procedure. Medications that are usually stopped before endovenous laser varicose vein treatment are:

• Medications that can thin your blood or prevent clotting (anticoagulants);
• All prescription medications;
• Over-the-counter medications such as aspirin or ibuprofen;
• Herbs, vitamins, and other supplements;

Follow instructions given to you regarding not eating or drinking before the treatment.

The Day of Endovenous Laser Varicose Vein Treatment

Endovenous laser varicose vein treatment takes 45 to 60 minutes. The entire procedure, including preparation and recovery time, takes about 1 to 3 hours. You can go home the same day. Once settled on a hospital bed, the treatment starts and includes:

• An imaging method, such as ultrasound, is used to guide the procedure;
• The leg to be treated receives an injection of numbing medication;
• Once your leg is numb, a needle makes a small hole (puncture) in the vein to be treated;
• The catheter containing the laser heat source is inserted into your vein;
• Further numbing medication may be injected around the vein;
• Once the catheter is in the correct position, it is then slowly pulled back. As the catheter delivers heat, the vein is closed;
• In some cases, varicose veins from other side branches may be removed or ligated through several small cuts (incisions);
• When the treatment is finished, the catheter is removed. Pressure is applied to the insertion site to stop any bleeding. An elastic compression stocking or bandage may then be put on the leg;

After Endovenous Laser Varicose Vein Treatment

What Happens After Endovenous Laser Varicose Vein Treatment?

Shortly after your endovenous laser varicose vein treatment, you will be allowed to go home. It is advisable not to drive, but to take public transport, walk or have a friend drive you. You will need to wear the compression stockings for a maximum of two weeks and the doctor will give you instructions on how to shower. You should be able to return to work and resume most of your normal activities immediately.

You cannot swim or get your legs wet during the period you are advised to wear stockings. Most patients feel a tightness along the length of the treated vein and some experience soreness in this area about 5 days later, but this is generally mild. Normal anti-inflammatory drugs such as ibuprofen are usually enough to relieve it.

Call your healthcare provider if you experience any of the following:

• Fever of 38°C or higher, or as indicated by your healthcare provider;
• Chest pain or difficulty breathing;
• Signs of infection at the catheter insertion site. This might include increased redness or swelling (inflammation), warmth, increasing pain, bleeding, or foul-smelling drainage;
• Significant numbness or tingling in the treated leg;
• Significant pain or swelling in the treated leg;

Will I Need Further Treatment?

If you are having endovenous laser varicose vein treatment solely for symptom relief, no further treatment is generally needed. However, most patients also wish to improve the appearance of their veins and about 80% will require some supplementary treatment. Spider veins normally become less obvious after endovenous laser therapy, but they rarely disappear completely.

Supplementary varicose vein treatment may be performed either by avulsion or sclerotherapy. These supplementary treatments may be undertaken at the time of the endovenous laser therapy or more usually after a delay of 4-6 weeks. If you have extensive varicose veins in both legs it is highly unlikely that you will be able to have all supplementary treatments at the time of the endovenous laser treatment.

 

Am I a Good Candidate for Endovenous Laser Varicose Vein Treatment?

Almost all patients with varicose veins are suitable for endovenous laser. The few patients who are not suitable, generally those with small recurrent veins after previous surgery, can usually be managed by simple sclerotherapy.

 

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