Endovenous Laser Treatment (EVLT) for Chronic Venous Disease of Lower Limbs at a Tertiary Care Center: A Descriptive Study

Abstract

Background: Chronic venous disease (CVD) in the lower limbs, mostly caused by reflux in the great saphenous vein, has typically been treated through surgical stripping. Recently, Endovenous Laser Treatment (EVLT) has come forward as a minimally invasive option, offering lower postoperative morbidity. This study aims to assess the short and midterm outcome of EVLT.

Methods: This cross-sectional descriptive research involved 64 adult patients suffering from CEAP C2–C6 chronic venous insufficiency who underwent EVLT at Nepal Police Hospital between March 2024 and February 2025. Patients were assessed using duplex Doppler ultrasound and treated with a 1470 nm diode laser alongside perivenular tumescent anesthesia. Outcomes were evaluated both clinically and sonographically one day, two weeks, and three months following the procedure.

Results: The average age of patients was 43.7 years, with a predominance of males (73.4%). The great saphenous vein was treated in 95.2% of limbs, while the small saphenous vein (14.5%) and incompetent perforators (30%) were treated less frequently. All patients reported pain and visible varicose veins; however, night cramps, bleeding, and skin discoloration were observed less often. Common complications included paresthesia (43.4%), superficial thrombophlebitis accompanied
by bruising (10.8%), pain (6%), burns (3.6%), and recanalization (1.2%), with no incidents of deep vein thrombosis.

Conclusion: EVLT is a safe, effective, and minimally invasive option for addressing chronic venous insufficiency, demonstrating high success rates and few complications. Continuous follow-up is essential to detect any rare recanalization. It is advisable to conduct larger studies with extended follow-up to confirm these results.