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Endovenous Laser ablation for Varicose veins

Endovenous Laser ablation for Varicose veins

23/02/2023

LASER VENOUS ABLATION EXPLAINED

Venous Ablation Therapy (Endovenous Laser Treatment [EVLT] is a minimally invasive option for treating venous incompetence (leaky valves).

1. The first stage of your procedure will involve inserting a catheter up the affected vein under Ultrasound guidance.

2. Your leg will then be numbed with a local anesthetic agent. During the second stage of the treatment, the catheter will be slowly retrieved.  As it is removed, it seals the affected vein closed. This will relieve the backflow pressure, which is causing your varicose veins. If we find any branches that need to be further addressed, we may treat them with a procedure called Ultrasound‐guided sclerotherapy or microphlebectomy and we will remove the veins with tiny small incisions. No stitches will be needed..

3. Following the procedure, we will put you in a compression dressing, which you will sleep in for 2 nights. You should then wear your compression garment for the next seven - ten days (or as instructed).  

LASER VENOUS ABLATION EXPLAINED 

 

Potential Risks and Side Effects 

All surgical interventions carry an inherent risk of infection, allergic reaction, bleeding and anesthetic complications. Below are possible risks and side effects that are specific to endovenous laser ablation.

 

Allergic reaction: While extremely rare, allergic reaction to the anesthetic agent can occur.  The risk of this is greater in patients who have a history of allergies.

Heavy leg: The leg may feel a bit heavy and and/or an uncomfortable sensation may run along the vein route. This discomfort is usually temporary and you will receive appropriate pain control.

Swelling: Usually occurs after treating veins in the leg. It usually resolves in a few days especially after treatment of large varicose veins. Wearing the prescribed compression stockings  lessens leg swelling.

Hematoma: Bruising is very common around the injection site and can last several days or weeks. Trapped blood may cause discoloration which resolves after several weeks. 

Infection: As with any surgical procedure there is a risk of infection. We use sterile techniques with all procedures to reduce this risk and you will receive antibiotics. 

Nerve trauma: Tiny sensory nerves run alongside your veins. Occasionally, there can be trauma to these surrounding nerves, which can result in altered sensation.  This may be described as burning, tingling, or pinpricks. These usually resolve with time. In rare instances, the localized sensation stays longer.

Bruising: It is very common after laser therapy, specifically around the treated area. It gets better day by day.  

Deep Vein Thrombosis: This is an unusual complication; and you will receive anticoagulation injection to protect you and oral tablets for the Flight back home if you are an international patient. 

Transient hyperpigmentation: Some discoloration after treatment is common. This discoloration is usually transient and usually resolves in less than three months. Very rarely lasts longer up to a year.  

Nodularity: At the site of vein treatment after laser you may feel your vein hard and some lumps under the skin. This occurs when there are pieces of the vein that remain in the body and have scarred down and become hard. With time, the body will absorb and soften these areas. 

 

What happens after surgery?

 

Postoperative instructions after Endovenous Laser

  1. We rest the first day and we try to keep our legs elevated 
  2. Stockings not to be removed the first 2 days
  3. We can remove the stockings after 48 hours to have a bath and remove some sticky strips that the doctor may have applied and you can keep wearing the stockings for 10 more days in the daytime and take them off in the evening. 

 

Medication:

  1. Ibuprofen 600 mg twice daily (for 10 days) 
  2. Antibiotics for 1 day 
  3. Paracetamol 1 gr once daily (for 7 days)

        Ordinary Routine:

  1. You can start walking from tomorrow and increase walking distance depending on your personal fitness. 
  2. Your leg may be bruised or feel your vein stiff under the skin but that's all normal and bruising will improve over time.  
  3. You can drive after 48 hours so that you feel comfortable with your leg and you can do the whole movement. 
  4. You can go back to the gym after 15 days starting with light weights and aerobic exercise. 
  5. You can fly 3 days after your procedure with your stockings on and one injection of Heparin in your tummy if the flight is more than 4 hours.
  6.  In the Summer you can go to the beach after 2 days but avoid long distance swimming and diving and prolonged sun exposure and keep yourself well hydrated. 
  7. If after 2 weeks you still feel in parts of your leg some lumps where the veins used to be or in other parts of the body that can be slightly tender not to worry those are the veins that are getting absorbed by the body and the symptoms will improve over time. You can take some painkillers or use voltaren gel over the area for 3-4 days.