EndoVenous Laser Therapy EVLT

EVLT is a minimally invasive procedure performed with local anesthetic. A sheath (tube) is inserted into the vein being treated using ultrasound guidance.
The laser energy (heat) is then applied heating the vein and sealing it closed as it is drawn out.

What to Expect

EVLT takes approximately 1 hour to perform. It involves minimal discomfort and has a quick recovery period. Compression therapy is used immediately following the procedure and patients are required to wear the compression stockings for 2 consecutive days and nights and then for an additional 2 weeks during daytime hours only.
Patients are unable to drive themselves home following this procedure and a driver must be arranged.

Common Effects of EVLT

Following EVLT it is normal to experience bruising along the treatment site as well as tightness that may feel like a “pulled muscle”. Stiffness, swelling and discoloration can also
occur over the treated area and will continue to progressively improve.
Patients are encouraged to walk and drink plenty of fluids.
An anti-inflammatory drug such as Advil or Aleeve, along with a cold compress or ice packs can be used to elevate any discomfort if necessary.

** Patients using blood thinners should not take anti-inflammatory drugs**

Before Treatment

  • You may eat and drink normally however please avoid products containing alcohol and limit the number of caffeinated beverages to one (i.e. coffee, cola, tea) this is to prevent constriction of blood vessels.
  • Ensure to bring your thigh-high compression stockings with you to your appointment. These must be 20-30mmHg compression strength unless otherwise indicated by the vascular surgeon.
  • Wear or bring comfortable, loose fitting clothing that can easily be worn over the compression stocking and bandages
  • Ensure you have arranged transportation home as you will not be able to drive for 24 hours following the procedure.

During the Procedure

  • Upon arrival you will be asked to change into a gown (if your undergarments are high-cut they may be left on)
  • The vein to be treated will be viewed on an ultrasound and a pre-treatment photograph will be taken
  • You will then lie on the procedure table and a cleaning solution will be used along the leg to be treated and sterile sheets will be placed around the area.
  • Local anesthetic (freezing) is administered at the access site and a needle is placed through the skin into the centre of the vein to be treated. Rarely a small incision is made.
  • A guide-wire is placed through the needle into the vein. It is possible to feel the wire but it will not be painful.
  • A sheath (tube) is placed over the guidewire and the correct position of the vein is established using ultrasound imaging. A laser fibre is then placed into the sheath.
  • Additional anesthetic will be administered along the length of the vein to be treated.
  • The laser is then turned on and pulled back along the length of the vein using heat energy to close the vein channel. The laser is usually on for approximately 5-6 minutes.
  • The laser is then removed and a small bandage is placed over the access site.

Immediately After Procedure

  • A bandage wrap will be applied around the leg and your support stocking put into place to apply pressure to the treated area.
  • We will encourage you to stand and walk for a few minutes to ensure bandages are comfortable and to promote circulation.

The First 48 Hours

  • The compression stocking and bandage must be kept on and kept dry.
  • You are encouraged to walk at a casual pace for limited durations.
  • Avoid prolonged periods of standing in place or sitting with legs downward. When sitting, elevate your legs.
  • You may apply ice packs on top of the bandage and stocking and/or take an anti-inflammatory (Advil or Aleeve) should you have any discomfort.
  • Drink plenty of non-alcoholic and caffeine free beverages to avoid dehydration
** Patients using blood thinners should not take anti-inflammatory drugs**

48 Hours to 2 Weeks

  • After 48 hours you may remove the compression stocking and bandage
  • We recommend a shower over a warm or hot bath at this time
  • Do not rub vigorously at the treatment area, wipe gently if needed
  • Continue to wear your compression stockings from morning to night (to be removed at bedtime) for 2 weeks
  • Bruising along the treatment site is normal and typically reduces within 2 weeks.
  • The varicose veins should be significantly smaller. Do not be discouraged by persisting veins, these will continue to diminish over the next 8 weeks
  • Some tightness over the vein is normal and may feel like a “pulled muscle”, we encourage you to continue to walk to reduce the tightness.

2 to 8 Weeks

  • A follow up appointment will be scheduled 4 weeks following the procedure. You will be informed at this time of your ability to return to full activities.
  • Vein branches will continue to shrink and/or disappear over time.
  • Stiffness, minor swelling or discoloration over the area can occur during this period and will progressively improve.
  • Sclerotherapy may be required for resolution of residual varicose veins or spider veins.
  • Regular daily use of compression stockings is recommended for continuing and sustaining optimal leg health.