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September 02, 2010  
EDUCATION CENTER: Vein Procedures
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  • Endovenous Laser Treatment (EVLT)

    Overview
    Reviewed by Richard Alweis, MD

    Endovenous Laser Treatment (EVLT) is a minimally invasive treatment for varicose veins. The procedure requires only one tiny incision the size of a needle, so there is a low risk of scarring or infection. The entire procedure takes less than one hour.

    Detailed Description
    Varicose veins are swollen, visible leg veins, usually caused by faulty valves in the veins. Veins carry blood from your body’s tissues to the heart. A series of valves lets blood flow in one direction but does not let it return. If those valves are not functioning properly, blood can back up, or "reflux," overfilling the veins. This causes the veins to swell and stretch. Varicose veins cause physical discomfort, and they are often considered unattractive.

    The greater saphenous vein is often the source of the problem. EVLT is a minimally-invasive surgical treatment that uses lasers to seal the greater saphenous vein without removing it. Smaller, healthy veins then take over the job that the larger vein could not do.

    Before the procedure, you will have a physical examination and an ultrasound to determine the source of the reflux. Only local anesthesia is used, so you will be completely conscious during the procedure, and only your leg will be numb. A needle is inserted into the greater saphenous vein, near the knee. The physician then uses ultrasound to thread a guidewire through the needle. A sheath will then be guided over that wire to the saphenofemoral junction. This is the junction between two main leg veins, the saphenous vein and the femoral vein.

    The guidewire is removed, and a thin, EVLT laser fiber is inserted through the sheath, and led to a point one to two centimeters below the saphenofemoral junction. Ultrasound is used to confirm that the laser is in the correct location. The fiber is then slowly withdrawn, and as it is pulled out, laser energy thermally seals the vein. Hand pressure is applied while the fiber is being withdrawn.

    The fiber and sheath are removed, and your leg will be cleaned and dressed. You will walk around the hospital for about 20 minutes, and then you will be discharged.

    Last updated: 05-Nov-03

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