Laser treatment for varicose veins of the lower limbs in Gdańsk

How does endovenous laser treatment work?

Varicose veins may develop when venous valves do not function properly, allowing blood to flow backwards, a condition known as venous reflux. During EVLA, laser energy is delivered through an optical fibre inserted into a selected incompetent superficial vein. This causes the vein to close, while blood continues to flow through other patent veins.

The procedure is performed under ultrasound guidance, usually with local anaesthesia. The aim is to reduce abnormal blood flow and symptoms associated with venous insufficiency. The extent of treatment is determined after examination, as the visible appearance of varicose veins does not reveal the full extent of the problem. [1]

Before the procedure: consultation and Doppler ultrasound

Patients are assessed for endovenous laser treatment after a consultation and Doppler ultrasound examination of the leg veins. Duplex Doppler ultrasound allows the doctor to assess venous anatomy, vein patency and the direction of blood flow, and to plan treatment. [2]

• the doctor discusses symptoms, previous treatments and current medications;
• assesses the venous system, including superficial venous insufficiency;
• determines which veins require treatment and whether laser treatment is appropriate;
• considers additional sclerotherapy and treatment of one or both legs;
• discusses costs, preparation, risks and the follow-up plan.

If you have previous Doppler ultrasound results or documentation of varicose vein treatment, bring them to your appointment. The doctor will assess whether the existing examination is sufficient or whether it needs to be repeated or supplemented.

Hybrid treatment: laser + sclerotherapy

Sclerotherapy is often used to complement endovenous laser treatment. The laser can close an incompetent main superficial vein, while sclerotherapy can treat selected dilated veins and tributaries requiring additional treatment.

Sclerotherapy involves injecting a solution into a vein to cause its closure. We call the combination of laser treatment and sclerotherapy a hybrid procedure. Both methods may be performed during a single session or in stages. The decision depends on Doppler findings, venous anatomy and the patient's individual circumstances. [3]

When should you book a phlebology consultation?

• you have visible varicose veins on your legs;
• you experience heaviness, pain or swelling in your legs;
• you notice skin changes associated with venous disease;
• varicose veins have returned after previous treatment;
• you want to find out whether laser treatment, sclerotherapy or another method is appropriate.

Leg swelling and pain can have various causes. The doctor will assess whether your symptoms are caused by venous insufficiency and whether the planned procedure may help reduce them.

How is EVLA performed?

1. Treatment planning. After assessing the patient, the doctor determines the procedure's course and scope and marks the areas to be treated.
2. Accessing the vein. Under ultrasound guidance, a thin optical fibre is inserted into the vein through a small puncture.
3. Anaesthesia. Local anaesthetic is administered around the treated vein. The injection may cause temporary stinging or burning.
4. Laser closure of the vein. Laser energy acts on the vein wall as the optical fibre is withdrawn.
5. Additional treatment when indicated. Sclerotherapy may be performed during the same session or scheduled for a later stage.
6. Post-procedure instructions. The patient receives recommendations regarding physical activity, any required compression therapy and follow-up.

The procedure may vary depending on venous anatomy and the scope of treatment. [4]

Preparation and return to normal activities

Bring a list of your medications and documentation of any previous thrombosis or varicose vein treatment to your consultation. Inform the doctor about allergies, pregnancy and chronic medical conditions. Do not stop taking anticoagulants or other medications without medical advice. Preparation and any additional tests are determined individually.

Walking and avoiding prolonged immobility are usually recommended after treatment. The timing of your return to work, sport and driving depends on the scope of the procedure, how you feel and the instructions you receive. If compression stockings are indicated, the doctor will determine their type and how long they should be worn. [5]

The doctor determines the timing of follow-up appointments and whether a post-procedure ultrasound is required, taking into account the course of treatment, symptoms and individual risk.

Possible side effects and complications

Following treatment, bruising, tenderness, a pulling sensation or hardening along the treated vein may occur. Sensory changes, skin discolouration, superficial vein inflammation and other complications are also possible. Thromboembolic complications occur less frequently. Sclerotherapy carries additional risks, including reactions to the injected agent. The doctor will discuss these before treatment. [6]

Increasing pain or new swelling in the leg requires urgent medical assessment. If you experience sudden shortness of breath, chest pain or fainting, call emergency services on 112.

Endovenous laser treatment of varicose veins – frequently asked questions

Book a consultation before varicose vein treatment

When booking, ask for a phlebology consultation concerning lower-limb varicose veins with Dr Arthur Abbazov. Our reception team will help arrange the appointment and the required Doppler ultrasound examination.

Wyspa Medycyny Przyjaznej · Gdańsk, ul. Toruńska 15, unit AU1
Telephone registration: Monday–Friday, 9:00 AM–5:00 PM.

General medical information sources

1. NHS – varicose veins and treatment options.
2. NICE CG168 – duplex ultrasound diagnosis and treatment assessment.
3. Royal Devon NHS – sclerotherapy, including its combination with laser treatment.
4. UCLH – varicose vein treatment, procedure and risks.
5. Doncaster and Bassetlaw NHS – recommendations after endovenous laser treatment.
6. Gloucestershire Hospitals NHS – sclerotherapy and possible side effects.

This information is intended to help you prepare for your consultation. The doctor determines suitability, the treatment method and its scope after examination. Results and recovery vary depending on the patient's individual circumstances.