ENDOVENOUS THERAPY

Introduction

Endovenous literally means 'within a vein' and endovenous therapy (sometimes referred to as Endovenous Laser Treatment 'ELT', or Endovenous Laser Ablation – 'EVLA') is a treatment for varicose veins using a laser inserted into the vein. A radiofrequency ablation probe may also be used. It is a modern minimally invasive alternative to the traditional surgical methods of treatment (known as 'ligation' and 'stripping').

Endovenous therapy has a much lower complication rate than surgical approaches with a success rate of over 98%*.

Preoperative Instructions

Prior to the procedure you should:

Continue any current medication unless advised otherwise by us

Avoid shaving the legs in the 3-4 days prior to the procedure

Avoid using any moisturisers or skin cream on the day of the procedure

Wear comfortable shoes and clothing (avoid tight fitting clothing, especially on the legs)

Do not eat or drink anything (i.e. ''nil by mouth') for the 8-hour period immediately prior to the procedure

Procedure

Endovenous therapy for varicose veins is generally a simple and comfortable procedure. The access area is numbed with local anesthesia to ensure your comfort. If your treatment involves laser or radiofrequency ablation (RFA), tumescent anesthesia—a solution of saline, local anesthetic, and epinephrine—will be injected around the vein to further minimize discomfort and protect surrounding tissues.

A small incision is made to insert a thin catheter into the affected vein, guided by ultrasound. You may feel slight pressure, but no pain. Depending on the chosen method—laser, RFA, or medical superglue—the catheter delivers energy or adhesive to seal the vein. You might experience mild warmth or a tingling sensation. Once the treatment is complete, the catheter is removed, and the small incision is covered with a bandage. The entire procedure usually takes 30 to 60 minutes per leg.In some cases, sedation or even general anesthesia may be an option if desired. Be sure to discuss this with your Doctor. Your Doctor will provide a full explanation of the procedure during your consultation and will be happy to answer any questions you may have.

Postoperative instructions

Immediately after the procedure you should walk for around 30 minutes or longer. If you are able to complete this walk unaided then you will be able to drive yourself back home. Once back at home you should take a minimum 30 minute walk every day for at least 14 days (or two to three 10-20 minute walks).

You will also be given some compression stockings ('Class 2') which should be worn for at least 14 days after the procedure. These prevent swelling in the legs and blood clotting and pooling. They should be worn during the night on the first night and after that only during the day. They should be taken off only for showers / baths.

You should also not wet the incision site/s in the 48 hours after the procedure. Any bruising to the legs should go away within 14 days.

During the 28 days after the procedure avoid:

Standing/sitting/lying down for long periods (when lying down elevate the leg)

Running/jumping/heavy lifting (but otherwise stay moderately active)

Hot baths

Going on long haul flights (i.e. over 4 hours)

During recovery if you notice any of the following contact us immediately:

Any sign of infection of the incision e.g. warmth, inflammation, leaking fluid (although some initial light pink fluid on the dressing is normal)

Swelling in the leg (either existing swelling getting worse or new swelling)

Significant pain

Risks

All surgical procedures carry some risk. Endovenous therapy is extremely safe but nevertheless the following potential complications may occur on rare occasions;

Bleeding

Bruising

Burns to the skin

Deep vein thrombosis ('DVT') / Pulmonary Embolism

Damage to nerves below the knee

Infection

Inflammation (of treated vein)

Pain

Skin discolouration (over treated vein)