Endovenous laser treatment, or ELT, is a technique used for the removal of varicose veins. Varicose veins typically develop in the legs, following failure of the valves inside them that normally prevent blood flowing backward. This back flow of blood may lead to veins becoming swollen and painful, and in some cases the skin lying over the vein may develop ulcers. While traditional varicose vein surgery involves tying off the vein before stripping it out, in endovenous laser treatment a laser is used to seal up the varicose vein from the inside. As a relatively new technique, endovenous laser treatment technique is still being evaluated, but, unlike conventional surgery, it does not require a general anesthetic, no incisions are made and recovery is quicker.
The endovenous laser treatment method is what is known as a minimally invasive ultrasound-guided technique. It is minimally invasive because, rather than requiring incisions as in conventional vascular surgery, the treatment is performed through tiny openings in the skin, resulting in less pain and faster recovery. Ultrasound scans are used to view the procedure as it is carried out.
Endovenous laser treatment is generally used to treat large varicose veins. People who have had varicose vein surgery in the past are less likely to be suitable for the procedure, although it may be possible for them to have the treatment in some cases. Before endovenous laser treatment begins, an ultrasound scan is used to determine the location of the affected vein.
After numbing the skin with a local anesthetic, a thin tube called a catheter is passed into the vein. The laser device is inserted into the catheter and moved to the top of the vein before being activated and slowly drawn along, back to the original insertion point. As it travels through the vein, the laser emits energy causing the blood vessel to seal and close.
Following endovenous laser surgery the leg remains bandaged for around a week. Walking is encouraged, starting soon after the treatment. Some pain and bruising may be experienced, the leg may feel tight and the skin may harden a little. These effects normally resolve by themselves.
Complications are rare but occasionally veins may become inflamed, or the skin of the leg may develop numb patches. Around 12 weeks after the procedure, most varicose veins will normally have shrunk or gone away. Any which remain may be treated using another technique known as vein injection, or sclerotherapy, where a chemical is used to seal the veins.