Varicose Veins

Treatments

Endovenous Laser (EVL)

Endovenous laser ablation (EVL) is a minimally invasive surgical procedure that uses laser heat to treat varicose veins. Laser energy is delivered to the inside of the great saphenous vein via an optical fiber that is inserted into the vein. When the laser is fired, it emits thermal energy at over 700 degrees Centigrade, perforating and destroying the vein walls and boiling the blood inside the vessel. The laser is repeatedly or continuously fired as the laser fiber is gradually withdrawn along the course of the vein, until the entire vessel is sealed by thermal damage and blood clotting.

Clinical data from one-year and two-year follow-up studies has shown EVL to be over 90% effective in keeping veins sealed, meaning less than one in ten patients experienced a recurrence of their venous reflux.

Studies indicate that the laser procedure is frequently uncomfortable for patients. In September 2003, the Journal of Vascular Surgery reported that two-thirds of EVL patients had post-operative pain, sometimes lasting several weeks, and more than half used prescription pain medication. Also, the laser energy frequently perforates the vein walls, forcing blood into the surrounding tissues and causing bruising and discoloration that can last weeks. Symptoms of pain and bruising are significantly higher with laser than with the radiofrequency-based VNUS Closure procedure, as confirmed by an independent comparative study.¹

Physicians performing EVL have experienced an additional drawback to the technique – the absence of technical feedback during the procedure. Unlike the VNUS™ ClosureFAST™ catheter , EVL devices do not provide the real-time data on variations in vein size or blood volume that would allow the physician to adjust how the laser energy is delivered or how fast the optical fiber is withdrawn. The lack of guidance can result in vein wall perforations or large blood clots.