Endovenous Laser Treatment (EVLT) - Varicose Veins (Single Extremity)

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Overview

They are superficial veins carrying blood,which creates pressure while standing. They look like spider webs and appears swollen and bulged. In worse case scenario they may cause pain at night experienced with some throbbing sensation in the legs.

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Before the Treatment

Laser removal of varicose veins is a simple procedure where heat is directed through laser to these veins causing the walls of the veins to collapse. By natural procedure of the body the damaged tissues are absorbed by the body and the veins are destroyed.

As a result of removal of superficial veins the circulation of blood takes place through deeper veins and happens more naturally and in a healthy way

How it is Performed

Except for a few, most patient of varicose veins problem can definitely go for the laser solution. However there may be some for whom foam sclerotherapy is more suitable.

Firstly an ultrasound scan is performed and the veins are demarcated with a pen. The leg in concern is cleaned nicely and covered in drapes before the patient is made to lie on a couch. The patient can face downward or backward depending upon the veins that require treatment. The steps are observed and guided with the aid of ultrasound scanning.

The doctor would now get inside the vein. A very minute amount of anaesthetic is injected along with a needle which is inserted into the vein. Through the needle a wire is passed up in the concerned vein. Over the wire a catheter is passed after the removal of the needle.

Through the tubing of catheter a laser fibre is made to pass in such a way so that the tip is present at the top most point which requires heating (most appropriate is the crease of the groin). Through an arrangement of multiple tiny needle pricks, large amounts of local anaesthetic solution is injected around the vein.

During the procedure the patient as well as medical staff are expected to wear safety devices like specs for precuation. The process of firing laser and pulling down the vein does not take more than 5 minutes. Sufficient amount of thermal energy is generated to the wall of the vein to induce occlusion, fibrosis and eventually resulting in the disappearance of the vein. Small amount of blood gets heated in the vein, apart from that some heating may occur due to the absorption of photon from the radiation incident on the vein.

Diode lasers are commonly used having a range of wavelengths. Lower wavelengths are haemoglobin specific including 810 n,, 940 nm,980 nm and 1064nm. Water specific higher wavelengths include 1320nm and 1470nm. Post procedure symptoms are expected to be low with higher wavelength lasers at lower power settings.

The patient can hear a warning buzzer and may also smell a burning odour or even taste it, but there will be no pain associated with it. If both the legs are supposed to be treated then one after the other is done. The laser and catheter is then gradually removed. The puncture created by the needle is covered with a dressing. The total treatment may not last more than half an hour.

The treatment may be followed by some foam sclerotherapy or some sort of avulsions may also be undertaken. After all this a compression stocking is put on the patient's leg.

Recovery

After your are done with the laser treatment, you will be allowed home. It is absolutely not advisable to drive at this point. Some stockings will be given to be worn for a specific period of time (almost 2 weeks), till then you are expected not to swim and also adhere to some basic guidelines about bathing and getting your legs wet. This surgery will enable you to get back to work immediately causing no trouble at all. Some amount of pain and swellings may occur which is normal and can be counteracted with medicines like ibuprofen. Ignore occasional tightening sensation in the legs. If pain persists then consult your physician.

How long will the effects last?

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