Endovenous Laser Treatment (EVLT): A Simple Medical Guide

Varicose veins are one of the common health problems affecting many people worldwide, especially adults who stand or sit for long hours. In India, this medical issue affects millions, but the cases often remain ignored and undiagnosed.

This article explains in simple words, right from understanding varicose veins, treatment to recovery and results. Now, modern medicine has a safe and efficient solution known as the Endovenous Laser Treatment, or EVLT procedure for effective and successful treatment of Varicose Veins.

What are varicose veins?

Varicose veins can be described as swollen, twisted superficial veins that usually occur along the legs. This condition occurs when valves within the veins cease to function correctly. Usually, such valves ensure that blood flows in one direction upwards toward the heart. Once weakened, blood starts flowing backward, pooling inside these veins, and thus they appear big and visible.

Common causes of varicose veins include:

• Long continuous standing or sitting

• Aging

• Pregnancy

• Obesity 

• Family history

They may cause pain, heaviness, swelling, itching, and even skin colour changes or ulcers if left untreated.

Why Varicose Veins Are Often Ignored in India

• Lack of awareness

• Believing that this is just a cosmetic issue

• Fear of surgery 

• Busy lifestyle

• Limited access to specialists in the country side or small towns

If varicose veins are neglected it may result into complications, such as ulcers of the skin, infections and clots.

What is Endovenous Laser Treatment (EVLT)

It is an advanced laser treatment for varicose veins. In EVLT procedure, a tiny laser fiber is inserted into the affected vein. Then, by using laser it closes off the faulty, affected vein from the inside. Once the vein is closed, the blood flows through the veins that are in good condition and the treated vein eventually disappears over time.

Why EVLT Is Used for Varicose Veins?

• It offers faster recovery compared to surgery

• It treats the main cause of varicose veins

• Relieves pain and discomfort              

EVLT procedure is currently one of the preferred treatments for varicose veins.

How EVLT Procedure Is Different from Traditional Surgery

Traditional surgery for varicose veins involves incisions, cuts to remove the diseased veins.

 In EVLT Procedure:

• Large cuts or stitches are not required

• Only local anaesthesia is used

• Less pain and bleeding

• Faster recovery

• Same day discharge     

Because of these above benefits, EVLT is regarded as safer and more comfortable for the patients.

Who needs Varicose Veins Treatment?

The following are indications when treatment for varicose veins might be necessary:

• Pain or aching in the legs

• Heaviness or tiredness in the legs

• Swelling of the legs or ankles

• Visible bulging veins

• Skin colour changes near the ankle

• Non healing leg ulcers

It is usually recommended for patients with symptoms that bother them in daily life and worsen over time.

Who May Not Be Suitable for EVLT Procedure?

EVLT may not be ideal for:

• Pregnant women

• People who have active infections of the legs

• Patients with severe blood clotting problems

Suitability, effectiveness of the EVLT procedure will be decided by a vascular specialist after examination and tests.

Preparing Patients for the EVLT Procedure

Before EVLT, the doctor may:

• Perform a doppler ultrasound to map the veins

• Enquire about medical history and medications

• Advise against stopping certain blood thinners

• Advise the patient to wear loose clothes

• May prescribe compression stockings

Patients for the EVLT Procedure is asked to eat lightly and stay hydrated.

Where Is EVLT Performed?

EVLT is performed in:

• Hospitals

• Specialized clinics

It is a day-care procedure, meaning that the patients get to go home the very same day.

Step-by-Step: What Happens During EVLT?

• Vein Mapping: It involves locating and marking the faulty vein by using ultrasound.

• Local Anaesthesia: The area is anaesthetised, numbed and the patient remains awake.

• Insertion of Laser Fiber: A tiny or small puncture in the skin is made, and a thin laser fiber is inserted into the vein.

• Delivery of Laser Energy: Laser heat closes the vein from the inside.

• Completion and Dressing: The fiber is withdrawn and the part is wrapped with compression bandages.

How Long Does the EVLT Procedure Take?

EVLT procedures generally take 30 to 60 minutes. Sometimes, if multiple veins are to be treated, then the procedure can take longer.

What Happens Immediately Following EVLT?

• Patients are encouraged to walk immediately

• Observed for a very short duration

• Most patients go home the same day

• Normal meals can be resumed 

Recovery After EVLT

Recovery is usually rapid

• Normal daily activities: 1–2 days

• Work: Within several days

• Compression stockings: These are worn for a few days or weeks

• Exercise: Light walking is encouraged

The doctors recommend not doing strenuous exercise for some time.

Possible Side Effects Following EVLT

Most of the adverse or side effects of EVLT are not serious. It is mild or moderate and reduces over time.

• Mild pain or discomfort

• Bruising

• Leg tightness

• Temporary swelling or numbness

These tend to get better over days or weeks in general. EVLT procedure is considered safe with high success rates. Serious complications seldom occur. Minor risks include bruising or temporary nerve irritations.

Recovery to Expect after EVLT

After EVLT, patients generally tend to observe the following:

• Reduced pain/heaviness

• Less swelling

• Improved appearance of legs

• Improved quality of life

The doctor may repeat an ultrasound to confirm that the vein is closed.

When to Contact a Doctor after EVLT Treatment?

Contact a doctor if you have the following symptoms:

• Serious or worsening pain

• Excessive swelling

• Redness or warmth of the leg

• Fever

• Infection signs

Importance of Early Treatment of Varicose Veins

Consulting the varicose veins specialist at the early stage prevents further complications.

• Prevents symptom aggravation

• It reduces the occurrence of skin damage and ulcers

• Improves comfort and mobility

• Increases the likelihood of successful treatment outcomes

• Ignoring varicose veins can lead to long term complications

The changing lifestyle, nature of work and lack of awareness make varicose veins a growing health concern for the people in India. It is a condition that, though common, should not be overlooked. 

Endovenous Laser Treatment of Varicose Veins, popularly known as EVLT procedure, is a modern and safe effective treatment. It is a treatment that gives relief from pain and ensures quick recovery. A finer understanding of the symptoms and early medical advice often help a lot.