EVLT Method

EVLT Method

Endovenous laser therapy (EVLT)

For the treatment of large varicose veins (trunk veins), we now mostly use endovenous techniques. This means that varicose veins no longer need to be operated on (“stripping”), but can be treated from the inside. This can be done under local anaesthesia. Patients treated EVLT are able to leave the clinic on foot after treatment, and have fewer complications and less post-operative pain compared to surgical stripping. In endovenous ablation, the inner lining of the leaking vein is damaged so that the vessel is closed off and the leakage is eliminated. There are two techniques to apply heat: the laser technique and the VNUS technique. We use laser technology to apply heat to the vessel wall.

The Wetering Medical Centre uses the EVLT method to treat varicose veins. A special laser catheter is inserted into the vein to be treated, and a local anaesthetic is administered by means of a few injections. The laser is then fired so that the tip of the catheter gets hot. This causes the vessel wall to shrink, and after a few days the vein will close up.
Depending on what needs to be done, the procedure takes approximately 15 minutes and is practically painless. The doctor will apply a pressure dressing or stocking, which may be removed after 24-48 hours.

Any questions?

If you have any questions, please contact us during consultation hours at 020 8203465.

Frequently Asked Questions about the EVLT method

What is the EVLT method and when is it recommended?

EVLT (Endovenous Laser Therapy) is a modern treatment for larger varicose veins in which the affected vein is closed from the inside using laser energy. A thin catheter is inserted into the vein, allowing the laser to heat the vein wall. This treatment is often advised when the valves in the main veins no longer function properly, which can lead to symptoms such as heavy legs, discomfort, cramping or swelling. EVLT is a minimally invasive alternative to surgical vein stripping and generally allows for quicker recovery.

How does an EVLT method work?

During the procedure, the doctor inserts a thin laser catheter into the faulty vein under ultrasound guidance. Several small injections are given around the vein to apply local anaesthesia. Once the area is fully numb, the laser is slowly withdrawn, heating the vein wall so that it collapses and eventually closes. The procedure typically takes 15–30 minutes and is performed on an outpatient basis. Afterwards, a compression bandage or stocking is applied.

Do I need to prepare for an EVLT treatment?

Preparation is simple. Wear loose-fitting clothing and comfortable footwear. Avoid lotions or creams on the leg on the day of the procedure. Bring an up-to-date list of your medications and inform the doctor if you are using blood thinners. Since driving yourself home is not advised, it is best to arrange transportation in advance.

Does the EVLT procedure hurt?

Because local anaesthesia is used, the EVLT treatment is usually not painful. The injections for anaesthesia can be momentarily sensitive. During the laser treatment, you may feel a warm or pulling sensation, which is normal. After the procedure, some tightness or mild discomfort along the treated vein can occur. This generally improves on its own and can be managed with paracetamol if needed.

What can I expect after the treatment?

It is common for the treated leg to feel tender or to show mild bruising in the first few days. A tight or pulling sensation along the former vein pathway is also normal. The compression stocking is usually worn continuously for one to two days, and optionally longer during the day if comfortable. After 24–48 hours you may remove the dressings and take a short, lukewarm shower. Avoid saunas, hot baths, swimming and strenuous exercise for the first week. Direct sun exposure should be avoided for several weeks to prevent skin discoloration.

When can I resume my normal activities?

Most people are able to walk and perform light daily activities the same day or the following day. Prolonged standing is best avoided. Depending on your job, you can usually return to work within one to two days. Listen to your body, if you feel tired or light-headed, take extra rest.

Are there risks or side effects?

EVLT is generally considered a safe procedure. Possible side effects include temporary bruising, mild redness, a tender area along the treated vein or small firm lumps under the skin. Occasionally, a superficial vein inflammation may occur. In rare cases, skin discoloration can develop, which often fades gradually over time.

When should I contact the clinic?

Contact the clinic if you experience a fever above 38.5°C, increasing pain despite pain medication, persistent bleeding, or if the leg becomes unusually red, warm or swollen.

Will visible varicose veins disappear after EVLT?

EVLT primarily treats the deeper main vein. As a result, smaller surface veins may become less visible over time, but not all will disappear completely. Additional treatments such as sclerotherapy, foam sclerotherapy or phlebectomy may be advised to treat remaining superficial veins.

Prices

Endovenous Laser Therapy (EVLT) €1200.00 (per leg)

Reimbursements

EVLT treatment is fully covered by health insurance.

Any questions?

If you have any questions, please contact us during consultation hours at 020 8203465.

Varicose veins EVLT method

EVLT (Endovenous laser therapy)

Endovenous laser therapy is a treatment suitable for the larger, so-called stem veins, and is performed under local anaesthesia. The varicose vein is punctured after which a special laser catheter is inserted. The varicose vein is cauterised with laser beams from the inside after the local anaesthetic is applied. The treatment takes about 30-45 minutes depending on the extent. After treatment, you will receive a pressure bandage with stocking for 48 hours, then only the stocking for 5 days during the day.

Before treatment

• We ask you not to use creams, lotions or bath oils on the day of treatment. Shaving is not necessary.
• Report anticoagulant use, and allergies to the doctor in advance.
• You may eat and drink anything before the procedure.
• Driving a car and cycling may be difficult due to the pressure bandage. Preferably take someone with you to accompany you.
• If you have therapeutic elastic stockings, please bring them with you.
• Wear loose clothing and shoes, as space is needed for the pressure bandage.

The treatment

Prior to treatment, another Duplex examination of the vessel to be treated is performed. You then take your place on the treatment table. Preparations for laser treatment take the most time. Disinfection of the leg, covering with sterile cloths, sterile preparation of the equipment. After a skin anaesthetic puncture, the vessel is punctured, after which the laser catheter is inserted. The duplex is used to check that it is in the right place. Then the area to be treated is numbed with a few punctures. The final laser treatment takes a few minutes. For safety reasons, everyone in the room will wear safety glasses.

After treatment

• Stocking and pressure bandage: a stocking and pressure bandage will be applied immediately after treatment. You may remove these yourself after 48 hours. You can then shower again. You will then wear the stocking for another 5 days, only during the day. The stockings can be washed at 30 degrees so that you can reuse them for any subsequent treatment.
• During the first two weeks, you are advised to exercise regularly (every hour) during the day, for example by walking, cycling or hiking. Prolonged standing is best avoided.
• Intensive sports (running, cycling, weightlifting, aerobics) are not recommended in the first two weeks after treatment, as are long car or plane trips or taking hot baths/showers/saunas.
• Sun exposure can stimulate pigmentation, use good sun protection

Possible complications and/or side effects

• Severe pain after the procedure is not common. In case of pain, you can take paracetamol (maximum 1000mg 4x daily).
• Bruising/bleeding may occur after treatment. Sometimes there is a pulling or sore feeling, or a strand can be felt. It may help to wear the support stocking longer if this feels comfortable.
• A rare but possible complication after treatment is the occurrence of deep vein thrombosis. This involves a clot forming in a deep, larger vein, blocking blood flow. Symptoms that may indicate this are: a severely swollen and/or painful leg.

In case of persistent severe pain, redness or swelling, contact us.

Check-up

A check-up appointment will be made after the treatment. Always bring the stockings with you so that any follow-up treatment can take place immediately.

Contact

If you have any questions or problems, please contact Medical Centre Wetering on telephone number: 020-8203465. Office hours: 08.30-16.30.

In case of emergency, the doctor can also be reached outside these hours on the same number, choice 0 from the menu.