Endovenous laser therapy (EVLT) is a minimally invasive treatment used to treat varicose veins. It involves using a laser fiber that is threaded through a catheter into the problem vein using ultrasound guidance. Once in position, the laser delivers thermal energy directly into the vein wall which causes the vein to seal shut. This process eliminates the unhealthy vein and improves blood flow through stronger, healthier veins.

How is it Performed?

The procedure is usually performed in an outpatient setting either in a hospital, surgery center or doctor’s office. The patient is given local anesthesia to numb the area before the procedure begins. Using ultrasound imaging, the physician is able to see inside the body and guide the laser fiber into the damaged vein. Once in position, the laser is activated and slowly pulled back sending pulses of thermal energy into the vein wall. endovenous laser therapy energy heats and seals the vein shut. External compression is applied after the procedure to help the vein collapse. The entire procedure takes 30–60 minutes depending on the number of veins being treated.

Benefits of EVLT

There are several benefits of endovenous laser therapy over traditional vein stripping surgery:

- Minimal recovery time — Patients are able to return to normal activities within 1–2 days with minimal bruising or scarring compared to several weeks with surgery.

- Less invasive — There are no large incisions made and general anesthesia is not required which reduces risks associated with surgery.

- Effective treatment — Clinical studies have shown EVLT to be as effective as surgery in eliminating varicose veins with success rates of over 90%.

- Fewer complications — Risks of infection, nerve injury and bleeding are much lower than open surgery since no large incisions are made.

- Improved cosmetic results — Scarring is minimized compared to the strip scars often left by traditional surgery. Bruising also fades more quickly.

- Local anesthesia — Patients remain awake and comfortable during the procedure since local anesthetic is used instead of general anesthesia.

Outcomes and Follow Up Care

Most patients experience significant improvement in symptoms such as aching, heaviness and swelling within a few weeks of endovenous laser therapy. Complete sealing and collapse of the treated vein takes 6–8 weeks on average. Compression stockings are usually worn for 2–4 weeks after to aid healing and prevent new varicose veins from forming. Follow up

ultrasound exams show over 90% closure of treated veins one year after EVLT. Recurrence rates are also lower than open surgery at around 5%.

Who is a Candidate for EVLT?

The best candidates for EVLT include those with:

- Varicose veins in the legs caused by vein incompetence (reflux)

- Bulging or twisted leg veins just under the skin (visible varicose veins)

- Aching, painful or heavy legs aggravated by standing or walking

- Skin changes on the lower legs like pigmentation or eczema caused by varicose veins

- Previously failed other treatments like sclerotherapy

Patients who have had deep vein thrombosis, active infections or bleeding disorders may not be suitable for endovenous laser therapy. The physician will assess each case individually to determine the best treatment approach.

Advantages Over Vein Ablation Techniques

While other non-incision treatments like radiofrequency ablation (RFA) and foam sclerotherapy are available, EVLT has some advantages:

- It treats larger vein diameters — EVLT can seal veins up to 10mm compared to around 57mm for RFA.

- Faster procedure time — Large vein sections can be treated more quickly than moving a catheter repeatedly with RFA or waiting for sclerosant foam to take effect.

- Durable results — Long term follow up studies have shown EVLT yields more stable closure rates of over 90% after 5 years compared to the 80–85% seen with RFA at that time point.

- Reduced side effects — No pain, bruising, induration or pigmentation changes commonly seen with sclerotherapy injections. Risks are also lower than phlebitic reactions possible with RFA.

With its success rates and advantages over other non-surgical options, endovenous laser therapy has become the standard of care for varicose vein treatment worldwide when patients and vein anatomy are suitable.

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Alice Mutum is a seasoned senior content editor at Coherent Market Insights, leveraging extensive expertise gained from her previous role as a content writer. With seven years in content development, Alice masterfully employs SEO best practices and cutting-edge digital marketing strategies to craft high-ranking, impactful content. As an editor, she meticulously ensures flawless grammar and punctuation, precise data accuracy, and perfect alignment with audience needs in every research report. Alice's dedication to excellence and her strategic approach to content make her an invaluable asset in the world of market insights.
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