Treatment for varicose veins have been underdevelopment for more than 2000 yrs but until the present era relatively little weight was given to cosmetic outcomes of treatment.Treatment ranges from ligation of great saphenous vein to stripping the greater saphenous vein & sclerotherapy. But these procedures have very high recurrence and are cosmetically incompatible.The newest & latest techniques for vein ablation uses thermal energy delivered to endovenous wall by means of laser. This is truly the first & indigineous minimally invasive & cosmetically acceptable approach for varicose veins for past 2000yrs.
EVLT works by thermal destruction of the venous tissues. It includes introducing a laser fibre into the vein & firing the laser while slowly withdrawing the fibre from the vein. The laser energy causes closer of veins because of optical absorption of laser energy in blood and water content of vein wall. We use the latest 1470nm laser wavelength which provides high chances of success with minimal patient discomfort as compared to previously used 980nm wavelength laser. The 1470nm wavelength leads to absorption of laser energy within the endothelium of vein wall rather than coagulation of vein, which leads to successful closure treatment of incompetent vein.
Performed under full consciousness under local anesthesia. The procedure is performed using high frequency ultrasound probe. It involves puncturing the affected vein (usually GSV & SSV) and introducing guide wire followed by a sheath. A 600micron laser fibre is introduced within the sheath & positioned just below saphenofemoral junction and fibre is fired and withdrawn continuously which causes destruction of vein wall leading to collapse ad occlusion of the parent vein. The complete closure of the vein can be immediately confirmed by Doppler examination & subsequent doppler follow ups.
The complete procedure takes 30 – 45 minutes, the patients can return to normal activities immediately with the exception of vigorous gym workouts.
Post procedure the pateint is advised to apply compression bandages for the entire limb for a week. Compression helps to close the retracted veins and prevents reopening.
Reticular veins are treated by making multiple puncture in vein using 21 G needle & using 200 micron fibre.
The latest 1470nm EVLT is useful for following procedures
- Endovenous treatment of great saphenous vein varicosities.
- Treatment of small saphenous vein varicosities.
- Treatment of branch varicosities
- Treatment of venous ulcers
- Treatment of reticular & spider veins.
- Minimally invasive
- Outpatient procedures not requiring general anaesthesia
- Minimally painful
- Marked reduction in rehabilitation time.
- Excellent cosmetic result with to scanning
- Short procedure time
- Excellent clinical and aesthetic results.