Get the answers to some questions you may have about Endovenous Laser Therapy

Apr 04,2017

Endovenous laser therapy is known by a number of proprietary names such as ELVes, EVLT, VeinSeal etc. depending upon the company that manufactures the laser. The general term for the treatment is endovenous laser therapy or ablation, as all the laser ablation types used are essentially identical.

  • What is ELVA?Endovenous laser ablation is a new technique deployed in treating varicose veins without any kind of surgery. In place of removing or tying, the abnormal veins are heated with a laser. The resultant heat kills the vein walls and allows the body to naturally absorb the dead tissue, thereby destroying the abnormal veins. The main advantage of this treatment is that it is non-invasive and can be carried out in a simple treatment room as opposed to an operation theatre.

  • Are my veins able to undertake the treatment? Most patients with varicose veins will be able to undergo ELVA. The unfortunate few who cannot (typically those with tiny, recurrent veins after a previous surgery) can be treated with simple foam sclerotherapy.

  • What happens after the treatment? After the treatment, the patient is allowed to go home. They are advised not to drive but use public transport, walk or have a relative or acquaintance pick them up. Stockings may need to be worn for up to two weeks and bathing instructions may be given. Normal activities can be resumed and one can head back to work almost immediately. The treated leg cannot get wet during the time that stockings are to be worn. Thus, swimming is strictly out of bounds. Most patients experience a tightening sensation along the vein and may feel some pain five days or so after the treatment but this is quite mild. Regular anti-inflammatory drugs such as Ibuprofen can easily resolve this.

  • Are all lasers similar? Most EVLA lasers used are nearly identical. A few types claim to cause less pain than the others. There may be some truth to this, however, the amount of pain experienced by patients with standard lasers is very minimal and is fairly easy to tolerate. The new lasers have not been extensively tested and it is still moot if they will be as effective in the longer term as standard lasers.

  • Is further treatment necessary? A large majority of patients prefer improving the appearance of their varicose veins and around 80% of them will need additional treatment. The veins certainly become less conspicuous after EVLA but they almost never disappear entirely. Additional treatment takes the form of foam sclerotherapy or avulsions. The two can be undertaken either during EVLA or 4-6 weeks after the treatment. Foam sclerotherapy is the most common method of treating residual varicose veins and is highly effective at it.

  • Can there be complications? Serious complications are very rarely encountered after EVLA. Nevertheless, they can occur and some of them are –

  1. Nerve damage – Nerves lie alongside veins and they can get damaged by heat or avulsions. Some patients even notice small numb patches on their skin that usually resolve within a few months.

  2. Burns – While it is exceedingly rare, burns are possible with EVLA.

  3. DVT – A deep vein blood clot in the leg is known as a DVT. It is recognised as a surgery complication and can be dangerous if the clot travels to the lungs. There have been a few reported cases of DVT post EVLA.

  • Which procedure should I choose? If one wishes to resume normal activities as quickly as possible, the following can be chosen –

  1. Foam sclerotherapy for those with less extensive veins willing to accept several recurring treatment sessions and the possibility of the varicose veins recurring in future. This is the least invasive.

  2. RFA is suited for those with a long, wide, straight vein segment that needs to be treated. Around 70% of the patients opt for this.

  3. EVLA is suitable for all patients and the vein length is irrelevant. The method and treatment results are identical to the first two.