How successful is EVLT?
EVLT is nearly 100% effective. If it does not work, it can often be repeated.
Does my body need the vein that is being sealed closed with EVLT?
No, the vein that is being sealed closed is an abnormal vein. The abnormal vein is causing your normal veins to work harder in returning blood back to your heart. Once the abnormal veins are removed, the normal veins will work more efficiently
The day of the procedure:
- There is little preparation required on your part prior to the procedure.
- Eat and drink whatever you would like; it is usually a good idea to do so.
- You need to have a driver come with you to the procedure.
- You DO need to bring the stocking that was prescribed at the time of your consultation (generally Class 2, 30-40 mm Hg compression). Do not wait until the day of the procedure to purchase the stocking since they may not have your size in stock.
- Some patients bring a book, magazine, or portable music player, but most patients pass the time of the procedure chatting with us.
- If you take aspirin or a blood thinner, please notify us as soon as possible. If it is safe, we may have you stop taking the aspirin one week prior to the procedure.
What to expect during the procedure
- Just before the procedure, it is a good idea to go to the bathroom.
- We will then have you change into a gown.
- An ultrasound will be performed, and the vein segments to be treated will be marked on the skin with a temporary surgical marker.
- This area will then be cleaned and sterile drapes will be placed on your legs.
- Local anesthetic will be administered at the site where a tiny catheter (like an IV) will be placed into the vein. Through this IV, the laser fiber will be inserted. You may feel a slight pinch when the numbing medicine is administered and a slight vibration in the vein as the laser fiber is passed within the vein.
- After the laser is positioned with ultrasound, the vein to be treated is numbed with additional local anesthetic. This is the longest part of the procedure and does involve several additional pinches, but it is intended to increase the safety and decrease the pain of EVLT.
- At this point, the laser is activated and withdrawn through the entire vein, sealing it closed.
After the procedure
- At the end of the procedure, the skin will be cleaned and sterile gauze will be applied and kept in place with an ace wrap.
- This part of the dressing is used to absorb the small amount of oozing of blood that normally occurs after removal of varicose veins and to add compression to the skin nick sites.
- The compression stocking is then placed over these dressings to apply additional compression
- You are free to get up from the procedure table and leave as soon as you like.
How long do I need to wear the stocking?
- The stocking placed at the end of the EVLT procedure should be kept on for one week. You can shower with the stocking in place as it dries very quickly.
- What are my activity restrictions and recommendations?
- After the procedure, you may immediately resume all of your usual activities except vigorous gym workouts, heavy weight lifting or long, hot baths.
- Frequent walking is strongly recommended for the first two weeks following the procedure.
- Prolonged sitting or standing should be avoided. Walking around the office and doing toe raises is recommended at work.
- Exercise and all of your usual activities may be resumed after one week, but the stocking should be worn during the first week back to full activity.
- You should not fly in an airplane for one month after EVLT. If you must fly, please let us know; we will ask you to come in for an ultrasound to ensure that you can do so safely.
Will I feel any discomfort after the procedure?
- Bruising after the procedure is expected and lasts 1-3 weeks.
- Some soreness over the treated vein may occur after EVLT for about 1-3 days which may require at most some Tylenol or Advil.
- The vein that was treated will experience a delayed pain that will feel like a pulled muscle with some stiffness.
- The pain usually feels the worst eight days following the procedure, improves after a few days and is gone by week two.
- The pain you will feel is normal and indicates that the vein is closing properly.
- It will be most apparent when you awaken or after sitting for a while. Stretching the leg and wearing the stocking may be helpful. If necessary, Advil or Motrin can be taken.
- It is normal to have soreness, slight swelling and redness along the treated area. These symptoms will disappear within the first few weeks.
Will insurance cover the procedure?
- About a month prior to your EVLT appointment, our office will check with your insurance company to see if the procedure is covered. Please be aware that the insurance company ultimately decides coverage of costs, based on its assessment of medical necessity.
When do I return for a follow-up visit?
- Check-ups are generally about 4 weeks after an EVLT. Complications that require medical attention are incredibly rare after this procedure, and they will be reviewed with you prior to the procedure.