Endovenous laser therapy (EVLT for short) is a minimally invasive procedure for the treatment of varicose veins. It is an alternative to surgical removal. Find out more about this treatment procedure here and find qualified doctors for endovenous laser therapy.
Endovenous laser therapy (EVLT or endovenous laser ablation (EVLA)) is a minimally invasive procedure to treat varicose veins (varicose veins).
Minimally invasive means that the intervention in the integrity of the body through surgical skin incisions is as small as possible.
EVLT is an alternative to surgical treatment of varicose veins. With EVLT, varicose veins are removed without a surgical procedure.
Instead, the doctor uses a laser to stick together and close the dilated vein (varicose vein) from the inside.
In other words, in a surgical procedure, doctors remove the vein through incisions in the skin.
With endovenous laser therapy, the vein is sealed from the inside. You do not have to remove it.
Both procedures aim to prevent discomfort that occurs when standing or sitting.
Endovenous laser therapy (EVLT) is a minimally invasive alternative to conventional treatment methods for varicose veins @ Svitlana /AdobeStock
As explained above, endovenous laser therapy is used to treat varicose veins. This is a very common clinical picture.
In Germany alone, 20 to 25 percent of women and 10 to 15 percent of men suffer from varicose veins. There are also non-visible varicose veins. Experts therefore assume that the number is even higher.
Varicose vein disease is therefore a "widespread disease". For this reason, there are several options and procedures for treating this harmless but chronically progressive condition. Chronic progressive means that it progresses and does not disappear on its own.
In earlier years, it was common practice to treat varicose veins surgically. The stripping method was considered the gold standard.
In this procedure, the doctor makes a 3 to 4 centimeter incision in the groin area. He then inserts a metal probe. This is inserted downwards through the varicose vein (towards the foot). Through an additional incision, he drains the varicose vein at the lowest point where the vein is dilated.
Since 1998, it has been possible to treat varicose veins from the inside (endovenously). The aim here is to seal and close the varicose vein.
If heat is used in the treatment (as with laser or radiofrequency therapy), this is referred to as a thermal procedure.
If doctors use liquid or foamy sclerosing agents (usually containing alcohol), which they inject into the vein, this is known as chemical endovenous therapy. An incision in the groin is not required for endovenous procedures.
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Theprinciple of foam sclerotherapy is to chemically irritate the vein walls and thus close the abnormally dilated blood vessel @ Solarisys /AdobeStock
Several European and American studies have demonstrated the positive effect of EVLT. After three years, only 3 percent of all patients experience a reopening of the vein.
This means that the success rate of EVLA even exceeds that of the stripping method. In addition, recurring varicose veins after a stripping operation or minor varicose veins can be successfully treated with a laser.
EVLT should only be used with extreme caution in very slim patients with little subcutaneous fatty tissue. Otherwise, the laser heat can cause skin burns. Temperatures of sometimes > 100 degrees Celsius are generated in the area of the catheter tip.
For this reason , doctors inject a liquid next to the vein during laser therapy to cool the tissue and skin. This allows them to minimize the risk of burns as much as possible. This special liquid (tumescent solution) also contains a local anesthetic, which is effective against post-operative pain.
Stripping surgery is the classic varicose vein operation in which doctors pull out the varicose vein after making an incision in the groin or back of the knee @ eliosdnepr /AdobeStock
Endovenous laser therapy is usually performed under local anesthesia.
First, the doctor injects the tumescent solution into the tissue. He then punctures the varicose vein just below the knee joint with a needle. If the varicose vein is superficial and visible, this can be done with the naked eye, otherwise he uses ultrasound.
He then pushes the probe of the laser device upwards in the varicose vein to just below the groin. He checks the position of the tip of the probe using ultrasound.
He then gradually and slowly pushes the tip of the probe downwards from above. As the probe is illuminated at the end, it is visible through the skin. During this withdrawal, the laser probe repeatedly emits pulses to coke the vein from the inside.
The treatment takes around 30 - 45 minutes and is performed on an outpatient basis. Immediately after the treatment, the patient is given a special compression bandage.
This supports the adhesion of the vein wall and reduces the pain symptoms. For this reason, it is advisable to wear compression stockings for 14 days.
Endovenous laser therapy offers the patient several advantages:
One disadvantage is that vein inflammation or vein thrombosis as well as perforation of the vein wall can occur more frequently after EVLA.
The method is not suitable for:
The risk of complications with endovenous laser therapy is considered low.
In some cases there is a risk:
Severe pain in the area of the blocked vein is also possible.
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