EVLT (EndoVenous Laser Therapy) is a modern method of minimally invasive treatment of varicose veins of the lower limbs and other forms of venous insufficiency of the lower limbs.

 

In patients with venous insufficiency, the blood in the veins does not circulate efficiently. Instead of flowing rhythmically towards the heart, the blood in the diseased veins of the lower limbs stagnates and backs up, which is referred to by doctors as venous reflux. The column of blood remaining in the lumen of the venous vessel initially leads to the widening of the vein, and finally to the formation of varicose veins. The longer the disease lasts, the larger and more extensive the varicose veins are. In addition to generating varicose veins, reflux of blood in the veins is responsible for a number of other pathological phenomena in the soft tissues of the limbs, which is the cause of a number of ailments, such as pain, fatigue, and swelling.

 

The method of treatment, popularly called "laser" by patients, consists in using laser energy to close inefficient venous vessels in the lower limbs. At the end of the laser fiber, introduced into the lumen of the inefficient vein, a high temperature is generated, which, acting on the vein wall from its inside, leads to immediate closure of the vessel, and secondly - to its fibrosis. In a vessel closed in this way, the blood stops flowing backwards, but continues to flow through the other functioning veins.

 

At the beginning of the procedure, the surgeon, using the ultrasound head, finds the lowest located fragment of the inefficient vein in order to insert the laser fiber into it, also under ultrasound guidance. Importantly, the laser fiber has a diameter of about 1 mm, so the surgeon only needs to puncture the vessel. Then, while observing the laser fiber in the ultrasound image, the surgeon usually inserts it in the groin area in the case of treatment of the saphenous vein or in the area of the popliteal fossa in the case of saphenous vein pathology. Subsequently, also under the control of the ultrasound image, the vein and the surrounding tissues are anesthetized with a local anesthetic so that the procedure can be performed in a painless manner. After activation of the laser, a high temperature is generated at the tip of the laser fiber, which, acting on the vessel wall from the inside, leads to its immediate closure. The surgeon, slowly withdrawing the laser fiber from the vein, closes the entire inefficient vessel.

 

The entire procedure ends with the application of a skin dressing at the site of insertion of the laser fiber and bandaging the limb with an elastic bandage, as well as putting on a compression stocking.

 

Due to the fact that the procedure is performed under local anesthesia, it is practically painless, and the patient can get off the operating table immediately after the procedure.

Virtually immediately after the procedure, the patient returns home and can perform normal daily activities. In the first period, pain may occur, but their intensity is relatively small and it is enough to take basic painkillers, such as paracetamol or ibuprofen, commonly available without a prescription.

 

Within 1 month after the procedure, it is advisable to wear compression stockings, which allows for a better cosmetic effect.

 

When it is necessary to treat more than one vein, the minimally invasive EVLT procedure makes it possible to do so. Simultaneous treatment of both lower limbs allows to shorten the treatment time to a minimum, as well as significantly reduces the costs of therapy.

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