Understanding Endovenous Laser Treatment...

The laser used at the Southern Illinois Vein Center is one of the newest lasers specifically designed to treat the larger superficial veins underneath the skin. The EVLA or EVLT procedure is done entirely in our office with local anesthetic. We only use local anesthesia so you will be able to drive yourself home after the procedure, eliminating the need to coordinate your visit with someone else. In this procedure your leg will be prepped with a sterile solution. You will have monitoring devices, such as a blood pressure cuff and pulse oximetry, on during the procedure. Local anesthetic is applied to the skin in the area of the leg where Dr. Robelen will enter the vein to be treated. He will use ultrasound to guide a hollow needle into that vein. (Remember there are no pain fibers inside the vein.) A guide wire will be passed through the needle and into the vein to hold the place in the vein. A catheter is then advanced over the guide wire which is then replaced with a laser fiber.

The laser fiber is about the size of a piece of angel hair spaghetti that has not been cooked. It has about the same stiffness. The laser is advanced through the catheter and into the vein. The heat the laser generates does not travel very far‚ so to ensure the entire vein wall is treated‚ Dr. Robelen must get the vein to collapse against the laser fiber. To accomplish this‚ a dilute numbing solution is placed around the vein under ultrasound guidance. This step can take anywhere from ten to thirty minutes depending on the length of vein to be treated.

Once the vein is entirely collapsed the laser procedure will begin. You will not feel the laser working‚ in fact‚ Dr. Robelen will ask you to tell him if you feel anything because at this point you should not. At the end of the procedure‚ compression hose will be applied and you will be given instruction on what and what not to do. You will be asked to walk for fifteen minutes after leaving the office. By itself‚ EVLA or EVLT is about 90% effective in treating venous disease which means there is about a 10% failure rate. That number is certainly better than the old stripping procedure which had about a 65% failure rate but none of our patients wants to be one of the 10%. In order to achieve a zero percent failure rate we must add another procedure to the EVLA or EVLT. That procedure is ultrasound guided sclerotherapy (UGS).
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