Endovenous Laser Therapy (EVLT)
What is EVLT?
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Why do you need EVLT ?
EVLT is indicated for:
- Varicose veins:
- Enlarged, twisted veins due to venous insufficiency (e.g., great saphenous vein reflux).
- Symptoms: Leg pain, swelling, heaviness, itching, or cosmetic concerns.
- Prevalence in India: 15–20% of adults; higher in women, older adults, and those with prolonged standing jobs (e.g., teachers, nurses).
- Other indications:
- Chronic venous insufficiency (CVI): Skin changes, ulcers (5–10% of untreated cases).
- Failed conservative treatments: Compression stockings, lifestyle changes (e.g., weight loss, leg elevation).
- Contraindications:
- Active deep vein thrombosis (DVT; risk of embolization).
- Inability to ambulate post-procedure (ambulation is key to recovery).
- Associated treatments:
- Pre-op: Ultrasound to map venous reflux (e.g., saphenofemoral junction incompetence).
- Post-op: Compression stockings (Class II, 20–30 mmHg) for 1–2 weeks; sclerotherapy for residual small veins.
- Timing:
- Performed in adults (average age 30–60 years); elective, scheduled based on symptom severity or cosmetic preference.
The procedure aims to relieve symptoms, improve leg appearance, and prevent complications like ulcers, with a high success rate for vein closure and symptom relief.
Why Do EVLT Costs Vary in Philippines?
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EVLT Procedure
- Before Procedure Evaluation:
- Assessment:
- Duplex ultrasound: Maps venous anatomy, confirms reflux (>0.5 seconds in great saphenous vein).
- Blood tests: Clotting profile (if anticoagulation history); routine tests often not needed.
- Physical exam: Assesses vein size, extent of varicosities, and skin changes.
- Preparation: No fasting; continue normal medications; wear loose clothing.
- Consent: Risks, including bruising, are explained.
- Assessment:
- Procedure Technique:
- Endovenous Laser Therapy (EVLT):
- Performed under local anesthesia with mild sedation (if needed), lasting 30–60 minutes per leg.
- Process:
- Ultrasound-guided access: Small needle punctures great saphenous vein (near knee or ankle).
- Catheter with laser fiber inserted; positioned just below saphenofemoral junction.
- Tumescent anesthesia: Lidocaine solution injected around vein to compress it, reduce pain, and protect surrounding tissues.
- Laser activation: Fiber delivers energy (e.g., 810–1470 nm wavelength), heating vein wall to 70–100°C, causing it to collapse.
- Fiber withdrawn slowly (2–3 mm/sec); vein seals shut; blood reroutes to deep veins.
- Closure: Small puncture site covered with a bandage; no stitches needed.
- Intraoperative Tools:
- Duplex ultrasound: Guides catheter placement and confirms closure.
- Laser fiber: Delivers energy (e.g., 1470 nm preferred for less bruising).
- Tumescent pump: Injects anesthetic solution.
- Endovenous Laser Therapy (EVLT):
- After Procedure:
- Hospital stay: Same-day discharge (outpatient).
- Care: Wear compression stockings immediately for 1–2 weeks; walk for 10–15 minutes hourly on day 1 to prevent DVT.
- Pain management: Mild discomfort for 1–3 days; managed with painkillers (e.g., ibuprofen).
- Instructions: Avoid prolonged standing for 1–2 weeks; no heavy lifting for 1 week; monitor for swelling or redness.
Recovery After EVLT
- Hospital Stay: Same-day discharge.
- Post-Procedure Care:
- Pain: Mild discomfort or tightness for 1–3 days; resolves in 1–2 weeks.
- Activity: Walk immediately (10–15 min hourly on day 1); avoid strenuous activity for 1 week; resume normal activities in 2–3 days.
- Compression: Wear stockings for 1–2 weeks (daytime); reduces swelling, promotes healing.
- Appearance: Varicose veins fade over 4–12 weeks; bruising resolves in 1–2 weeks.
- Symptoms: Pain, heaviness improve in 1–2 weeks; 80–90% report significant relief.
- Follow-Up:
- Visits at 1 week (check healing), 1 month (assess symptom relief), and 3–6 months (ultrasound).
- Ultrasound: At 1 month to confirm vein closure; 95–98% closure rate at 1 year.
Most resume normal activities in 2–3 days; full recovery takes 1–2 weeks. Success rate: 95–98% vein closure at 1 year; 80–90% symptom relief; 5-year recurrence rate 5–10% (new veins may develop).
Risks and Complications
- Procedure Risks:
- Bruising (20–30%): Around treated vein; resolves in 1–2 weeks.
- Pain (10–20%): Mild burning or tightness; managed with painkillers.
- Skin burns (<1%): From laser heat; rare with tumescent anesthesia.
- Post-Procedure:
- Deep vein thrombosis (DVT, 0.5–1%): Clot in deep veins; minimized by walking, stockings (links to your embolectomy query).
- Numbness (2–5%): Temporary nerve irritation (e.g., saphenous nerve); resolves in 1–3 months.
- Infection (<1%): At puncture site; treated with antibiotics.
- Recurrence (5–10% at 5 years): New varicose veins; may need sclerotherapy or repeat EVLT.
- Long-Term:
- Neovascularization (2–5%): New vein growth at junction; may cause recurrence.
- Skin discoloration (1–3%): Brown staining; fades in 6–12 months.
Report fever, severe swelling, chest pain, or shortness of breath (DVT/PE signs) promptly.
Frequently Asked Questions (FAQs)
What causes the need for EVLT?
Varicose veins from venous insufficiency, causing pain, swelling, or cosmetic concerns.
Can I avoid EVLT?
Yes, if mild: Compression stockings, leg elevation, weight loss; EVLT needed for significant symptoms or cosmetic goals.
Is EVLT painful?
Mild discomfort for 1–3 days; managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: Immediately (walking encouraged); full recovery: 1–2 weeks; avoid strenuous activity for 1 week.
Is EVLT covered by insurance in India?
Coverage varies (often considered cosmetic unless symptomatic); confirm with your provider; Ayushman Bharat may apply for severe cases.
Signs of complications?
Fever, severe swelling, chest pain, or shortness of breath.
How long do EVLT results last?
95–98% vein closure at 1 year; 5–10% recurrence at 5 years; new veins may form over time.
Lifestyle changes post-procedure?
Wear compression stockings, avoid prolonged standing, maintain healthy weight, exercise, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for EVLT
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.