Endovenous Laser Therapy (EVLT)
EVLT is a minimally invasive procedure which permanently closes off the greater or lesser saphenous vein of the leg, or both, making surgical stripping of the vein unnecessary. The procedure is performed through a tiny skin incision, resulting in minimal or no post operative scarring. The treatment, which is performed with oral sedation and uses a local anesthetic, typically takes about an hour. After 20 minutes you will be able to leave, walking and wearing a compression bandage.
FREQUENTLY ASKED QUESTIONS
What is the EVLT procedure like?
After a local anesthetic is applied, the radiologist will use ultrasound to guide a catheter and laser fiber into the greater saphenous vein (GSV) of your leg through a small puncture near the level of the knee. The catheter is then advanced to the level of the groin, typically without causing discomfort. A dilute local anesthetic is infused around the length of vein to be treated. This process requires several needle sticks. When properly positioned the laser is activated and slowly withdrawn. Heat energy from the laser injures the wall of the treated vein. Ultimately, the vessel scars and shrinks down. Branch vessels of the treated vessel also benefit, becoming less prominent. The treatment typically takes about 30 to 60 minutes.
How should I prepare for an EVLT?
You must first schedule a leg vein ultrasound and consultation with the interventional radiologist to determine if you are a suitable candidate for the procedure. If the ultrasound shows that you are not a candidate, the consultation will be cancelled. If you are a candidate, a pre-certification process may need to occur with your carrier prior to the procedure.
Discontinue Coumadin (Warfarin), Plavix (Clopidogrel), Ticlid (Ticlopidine), and Pletal (Cilostazol) with permission from the prescribing physician for 5 days prior to the procedure. If you take Coumadin (warfarin), a Prothrombin time (PT) and INR will be obtained at the clinic before the EVLT.
Discontinue low-molecular weight heparin therapy with Lovenox (Enoxaparin), Fragmin (Dalteparin), Normiflo (Ardeparin), or Orgaran (Danapararoid) with permission from the prescribing physician for 24 hours prior to the EVLT.
Arrange for someone to drive you home after the procedure.
What should I do after an EVLT?
You should go home and relax, with the treated leg elevated. Three times during the afternoon, you should walk around the house for twenty minutes. A non-steroidal inflammatory agent will be prescribed to avoid inflammation and pain. Compression stockings will need to be worn during waking hours for 3 weeks. You can take a shower 24 hours after the procedure, and can drive the day after the procedure. Typically, non-strenuous activities can be resumed the next day, and more strenuous activities over the next several days. A detailed instruction sheet is provided after the procedure.
You will be asked to return for an ultrasound within 2-5 days to ensure the vein has been completely sealed, as well as 3 weeks and 3 months after the procedure.
28 White Bridge Road
Suite 111
Nashville, Tennessee
37205
Phone (615) 356-3999
Fax (615) 353-0462
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