Endovenous Laser Therapy (EVLT)
More recently, endovenous laser therapy has been developed to treat chronic venous insufficiency by delivering laser energy through a small puncture in the leg to close the diseased vein. With endovenous laser therapy, no surgery is required, and the entire procedure can be performed in less than one hour in your physician's office. During the procedure, you are awake and your leg is locally anesthetized. A thin laser fiber is inserted into the greater saphenous vein in your thigh. Your physician will then deliver laser energy through the fiber and into the vein, causing the vein to close. Laser energy is usually delivered in the thigh, even when varicose veins are located below the knee. This is because bulging varicose veins in the lower leg are often caused by a faulty valve located higher in the leg that can't be seen at the surface. Endovenous laser therapy treats the source of the problem, which then causes the varicose vein in the lower leg to shrink and disappear. Although individual responses vary, most people report little to no pain associated with endovenous laser therapy. Often the only sensation is felt during the delivery of anesthetic to the leg. After the procedure you may feel some tenderness, tingling, itching or tightness in the treated leg, which should disappear within a month. Clinical results of endovenous laser treatment have been published and show an overall success rate of over 98%. These results are superior to those of traditional surgery.
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Previously, the treatment of painful, swollen varicose veins required a surgical procedure called vein stripping, involving the complete removal of the vein from the leg. It required an operating room and general anesthesia.
