Sievering Clinic

Competence Centre for Minimally Invasive Medical Services


Minimally invasive treatments

Endoluminal Laser Ablation (ELVA, ELVeS, EVLT)

endovenouslaserLasers have been used for numerous medical applications throughout the body. Recently, a novel technique utilizing laser energy delivered “endovenously” (directly inside the vein) has been developed to treat varicose veins. The use of lasers has become an accepted alternative to surgical stripping to remove varicose veins. A 980 nm diode laser is used to deliver the laser energy via a small laser fibre. The procedure, termed the Endovenous Laser Procedure (EVLP, ELVeS), or Laser ablation (EVLA) is performed under local anaesthesia. A tiny laser fibre is first inserted into the diseased vein through a tiny needle (venipuncture) in the skin similar to blood sampling in a laboratory. After he Laser has been positioned energy is then delivered through the fibre, which causes the vein to close as the fibre is gradually removed.

EVLA is optimal for treatment of:
  • Greater saphenous vein
  • Small saphenous vein
  • Branch varicosities
  • Reticular veins
  • Spider veins
  • Telangiectasia
  • Venous ulcers

ELVeST is also useful in the management of wound care and constitutes an alternative treatment that is free of side effects.

Endovenous Treatment of Sapheneus Veins
The treatment of venous incompetence of the lower limbs by endovenous laser under ultrasound guidance is easy to perform in either treatment room or operating theatre setting.
Using only local anaesthesia it provides a minimally invasive, less traumatic and cosmetically optimal solution to this condition.
This endovascular technique leaves no scars and minimises the risk of infection and post-operative pain. Excellent clinical and aesthetic results have been observed with greatly reduced procedure costs.
How ELVeS works
  • Following percutaneous entry into the greater saphenous vein, a fine ELVeS laser fibre is inserted into an introducer sheath and advanced towards the sapheno-femoral junction.
  • Once in position (confirmed by ultrasound and the laser aiming beam), the near infrared laser energy is delivered in short pulses, causing thermal damage and contraction of the vein wall. Due to the application of tumescent local anaesthesia damage of surrounding structures is inhibited.
  • The laser treatment is performed along the entire vessel length. The irreversible thermal damage induced by the laser energy then leads to a complete occlusion of the vein.
  • The complete procedure takes about 30-45 minutes; the patients can return to normal activities immediately, with the exception of vigorous gym workouts.
Endovenous Treatment of Branch varicosities and reticular veins
Branch varicosities and reticular veins can also be treated under direct visualization by a similar endovascular technique.
This method is faster and more efficient than conventional treatments. The procedure is well tolerated with rapid patient recovery.

Experiences in more than 1000 patients have proved a high success rate in vessel closure. Positive patient feedback has been reported 2 additionally attributed to the fact that side effects as skin blanching or pigmental disorders are a non-issue.
The endovenous treatment can also be performed on patients taking anti-coagulants or with impaired circulation.

Transcuteneous Treatments of Spider Veins and Telangiectasia
Anaesthetic Telangiectasia and Spider Veins are frequently observed in patients presenting varicose veins. These tiny veins can be treated transcutaneous with the same laser system combined with the ELVeS focusing hand-piece.

  • The near infrared laser energy is well absorbed by haemoglobin and easily penetrates to underlying tissue with low absorption in the dermis.
  • The surface tissue is unaffected by the laser energy as it is defocused at this level and anaesthesia is not necessary. Vessels up to 1.5 mm in diameter can be successfully treated by this technique.
Wound Healing for Venous Ulcer
Laser light is well known to have beneficial effects on healing wounds. The treatment of wounds with the ELVeS wound healing hand-piece encourages the wound healing process, significantly reducing the healing time.

  • Low-level laser energy is applied to the wound in criss-cross pattern to ensure complete exposure. This photo-stimulation effect is specifically noticeable in treatment of diabetic foot ulcers.
  • The laser treatment induces a positive effect in conditions of reduced microcirculation and results in the stimulation and proliferation of the patient’s own cells.