Endovenous laser ablation is one of the newest procedures established for treating large incompetent veins. EVLT uses a thin laser fiber to deliver a concentrated and precise amount of energy to the vein, resulting in long term closure. It typically eliminates one of the main superficial veins which are usually the greatest contributors to both symptoms and varicose veins. It is performed under ultrasound guidance allowing for the most accurate treatment possible. Unlike surgery for vein stripping, it does not require general anesthesia which is one of the biggest risks with most surgeries. Furthermore, Endovenous laser ablation is able to provide treatment with virtually no downtime with minimal to no discomfort.
Once the vein is closed, the previously experienced symptoms start to improve and often within days after the procedure. The size of the associated varicose veins will reduce in size and become less visible after the treatment. This also can be seen as soon as days following the procedure and can continue to improve over weeks to come.
Endovenous laser ablation is unfortunately not covered under the Ontario Health Insurance Plan (OHIP) or the Régie de l’assurance maladie Québec (RAMQ). The cost of the procedure can be submitted to personal health insurance for possible reimbursement.
How should I prepare for the treatment?
Patients should wear clothing that is either short or loose enough to allow the treatment area to be exposed. Compression stockings are an important part of your post-treatment care. Please do not forget to bring your compression stockings to your appointment so they can be put on right after the treatment. You should avoid applying any type of lotion, cream, or gel to the treatment area on the day of your appointment. Although we do clean your skin during your treatment, we strongly recommend that you wash the area at home.
How many treatments will I need?
The number of treatments required varies with each individual. The initial assessment will help give an estimate number of appointments so patients can have an idea. It is always difficult to know the exact number due to the wide range in the type, size and number of concerning veins as well as the variability in response to treatment.
With EVLT, the entire targeted segment of vein is typically treated in one appointment. If a patient has more than one vein that can be treated by EVLT, additional veins can be done in the same appointment.
It is very important for patients to known that the treatments are not a permanent cure of the condition. You can eliminate your presently concerning veins, however you may still produce additional varicose veins in the future. Therefore, it is important to maintain good overall health and continue to practice preventative measures in order to reduce the risk of future varicose veins.
Are the treatments painful?
The procedure is performed using a form of local anesthetic that allows the vein to be treated by the laser without the patient feeling any pain. Most veins, even very long segments, are able to be treated with a single poke of a needle to access the vein. Certain veins can be sore after the treatment; however most patients don’t find it severe enough to take any pain medication. This is quite minimal in comparison to its older alternative of vein surgery, which typically results in a significant amount of pain often requiring stronger pain medication.
What can I expect after treatment?
Following EVLT, steri-strips and bandages will be applied to the treatment area. The bandages need to be kept on till the following day while the steri-strips are to be kept on for 1 week. Compression stockings will be applied shortly after the completion of the treatment. Patients are required to wear compression stockings post-treatment to help give the best possible results as well as reduce the risk of complications. The compression stockings are worn for 3 weeks post-treatment unless instructed otherwise. Patients are advised to walk regularly on a daily basis. It is best if you avoid more strenuous physical activity for a few days and possibly up to a week or two following your treatments.
Bruising at the treatment site is common. A larger bruise can occasionally form. Mild tenderness, either at the entry site or along the vein, can be experienced. This can last from days to weeks and occasionally a few months; however it is often not severe enough to require any form of pain medication. Finally, the vein becomes hard after the treatment and can be felt as a tightness or pulling sensation. This most commonly occurs several days after the procedure and typically lasts days to weeks.
Dr. Amyot and his team are the only Ottawa originated centre that is able to offer this advanced treatment option for venous disease and varicose veins.