EVLT involves the introduction of a thin tube (catheter) into the main superficial vein on the inside of the thigh through a small skin incision over the inside of the knee. The procedure is performed with the patient awake and a local anaesthetic is used to numb the leg so that no discomfort is felt. The laser catheter is passed up the vein to the point of connection with the deep vein at the groin. Ultrasound scanning is used to accurately position the tip of the catheter where the fibreoptic laser probe is sited. Activating the laser results in a heating effect inside the vein causing it to seal up. This usually causes varicose veins lower down in the leg to either shrink or disappear over time in 50% of patients. Foam sclerotherapy (outpatient procedure) can be used after 4-6 weeks in cases with residual calf veins.
The whole procedure takes less than 1 hour to perform and allows patients to return to their normal routine within 24 hours. The technique is successful in around 95% of cases.
The 3 year follow-up results after EVLT are comparable, if not better, than open surgery.