For the minimally invasive treatment of varicose veins
Frequently Asked Questions
about Minimally Invasive Varicose Veins surgery
Q: What is EVLT ?
A: EVLT is a minimally invasive way of treating varicose veins. Instead of making a cut in the groin and stripping the vein from the thigh, the surgeon uses a fine laser fibre to zap the vein from the inside.
Q: What are the advantages of EVLT?
A: EVLT is less painful than open surgery and people return to work faster than after open surgery. There is less bruising and there are no incisions in the top of the leg. EVLT can also be done under local anaesthetic without the patient being put to sleep.
Q: What happens to the vein after it has been treated?
A: The body absorbs it and it disappears naturally
Q: If I have a local anaesthetic how painful will the operation be?
A: Under local anaesthetic you will need to have a few injections during the operation. We use a very tiny needle but it is still a little bit uncomfortable – it is a bit like going to the dentist.
Q: Do I have to have a local anaesthetic for EVLT?
A: No. If you are scared of having a local anaesthetic, you can have a general anaesthetic instead.
Q: Do I have to stay in hospital after EVLT?
A: Rarely. The vast majority of patients go home on the same day as the treatment with bandages on the legs and painkillers
Q: How painful is EVLT?
A: Remarkably painless. Most patients find they need to take painkillers for a few days only. Sometimes patients can feel the treated vein as a tender cord in the thigh after the operation, but this feeling goes away within a couple of weeks.
Q: Is the laser dangerous?
A: The laser is dangerous if you look at it directly. However full laser safety precautions are taken during the operation. Everyone in the operating theatre has to wear special glasses during the laser phase of the procedure to be sure that there is no risk.
Q: What are the complications after EVLT?
A: Remarkably few. The commonest complication is a vein irritation that lasts a couple of weeks, but very few patients get this.
Q: Can I get a Deep Vein Thrombosis after EVLT?
A: Theoretically anyone can get a DVT after any surgical procedure. However, the risk of DVT after EVLT is very low (less than 1 in 400).
Q: How long do I wear the bandages for?
A: The bandages are worn for 5 days then soaked off in the bath and replaced by a compression stocking which is then worn for 2 weeks. Mr Chaloner or Mr Sweeney will measure you personally for the correct size of stocking.
Q: What follow up procedures are necessary?
A: Quite often no further procedures are required. At 6 weeks if there are any small veins left over in the calf, they can be removed under local anaesthetic by making some tiny (2 millimetre) nicks in the skin, or by injecting them with a chemical (sclerotherapy – more info below).
Q: Who will do my operation if I have private treatment?
A: Mr Eddie Chaloner or Mr Aaron Sweeney. They are consultant vascular surgeons who work at 4 BMI Hospitals in the SE London Area. You can be seen at Blackheath, Chelsfield Park, The Sloane Hospital or Shirley Oaks in Croydon. Alternatively you can be seen at the Lister Hospital in Chelsea
Q: How experienced with this technique are Mr Chaloner and Mr Sweeney?
A: Mr Chaloner and Mr Sweeney have been doing EVLT for 3 years. They were the first surgeons in the London area to learn the operation. They have performed well over 400 EVLT operations and run training courses in the technique for surgeons from all over the UK and Europe. Their work has been featured in several UK papers and magazines including The Times, the Mail on Sunday and The Daily Telegraph.
Q: Do Mr Chaloner and Mr Sweeney do open varicose veins surgery as well?
A: Yes. They offer a complete varicose vein treatment service incorporating the full range of techniques.
Q: Is EVLT available on the NHS?
A: Not widely at this time. Mr Chaloner and Mr Sweeney do offer EVLT on the NHS at Lewisham Hospital where they treat approximately 25 patients per month
Q: How long will I need to be off work after EVLT?
A: Latest studies suggest the average time off work is 3 days after EVLT – compared with 12 days after open varicose vein surgery.
Q: When can I drive after EVLT?
A: It depends. The majority of people will be OK to drive after 3 – 4 days but it is important to check with your car insurance company that they will cover you after an operation.
Q: When can I go to the gym / start exercise after EVLT?
A: This varies a bit between patients – generally speaking it is advisable to avoid heavy exercise for a week or two while the healing process takes place. You are unlikely to harm yourself if you exercise sooner, but it might hurt a bit!
Q: Does EVLT work as well as open surgery?
A: Yes. In fact the latest studies suggest it works better as far as recurrence of the veins is concerned.
Q: Can veins come back after EVLT?
A: Yes they can, but as mentioned the latest work suggests that this is less common than after open surgery. The figures suggest that about 7% of patients will get some recurrence at 3 yrs post op.
Q: Is everyone with varicose veins suitable for EVLT?
A: No. About 70 % of people with varicose veins are suitable for EVLT. You will need a consultation with Mr Chaloner or Mr Sweeney to decide if you are suitable.
Q: What if I am not suitable for EVLT?
A: You will be offered open surgery for your varicose veins if you wish it.
Q: Will my insurance pay for EVLT?
A: All the major health insurers (BUPA; PPP; Norwich Union; WPA; Standard Life) will cover EVLT treatment
Q: I am not insured. How much does EVLT cost?
A: The BMI Hospitals have a fixed price package scheme for EVLT. Cost depends on whether you need one or both legs treated.
Q: What is foam Sclerotherapy and is it useful?
A: Foam sclerotherapy is a technique where a chemical is mixed with air to make a foam. The foam is then injected into a varicose vein. It can be used to treat big varicose veins but Mr Chaloner and Mr Sweeney think that it is not as effective as EVLT when used in this way. Foam Sclerotherapy is useful for treating any smaller varicose veins that might be left over after EVLT
Q: What is VeNUS Closure?
A: VeNUS Closure is a surgical technique similar to EVLT. However, it takes longer to perform, has to be done under general anaesthetic and is more expensive. We do not think it is as good as EVLT.
Q: What are thread veins and can they be treated?
A: Thread veins are tiny little veins in the skin that are related to varicose veins and are very common. They can usually be treated by simple injections. More information on this is available on the Thread Veins page.
Secretary and Appointments: 0845 0451160; Vascular Hotline: 07855 455 855
EVLT is a trademark of Diomed Inc.
The London Surgical Clinics gratefully acknowledges the support of Diomed in giving permission to use their graphics on this website.
Copyright London Surgical Clinics Ltd 2006