EndoVascular Laser Therapy (EVLT) is a technique that causes thermal ablation of major truncal varicosities. Most frequently these are varicose veins related to the long saphenous vein. The long saphenous vein runs from the front of the ankle and up the inner side of the leg to join the deep venous system at the saphenofemoral junction. The direction of blood flow in this vein is maintained by one way valves, the most important of which is situated at the saphenofemoral junction. When this valve becomes damaged the blood can flow in the wrong direction and veins in the distribution of the long saphenous vein become dilated and stretched resulting in varicose veins. Obliteration of the long saphenous vein can stop this from happening.
A similar process can occur with the short saphenous system which runs from the outside and the back of the ankle, up the back of the calf to drain into the saphenopopliteal junction behind the knee. Treatment of varicosities in the distribution of the short saphenous system is similar to that for varicosities in the long saphenous system.
Occassionally varicosities are associated with calf perforating veins on the inner side of the calf between the ankle and the knee. Similarly these can be treated by direct EVLT.
Treatment by EVLT is performed under local anaesthetic sometimes with a small amount of sedation. The patient can go home on the same day as the treatment with their leg bandaged from foot to groin. Post procedural pain is not a common feature of this treatment. Patients are usually able to return to work the following day.