Cooltouch Laser Ablation

This treatment is performed in my main consulting suites (Epworth, Richmond) in a specially designated room for endovenous treatments. Initially after the main saphenous trunk is marked by ultrasound, a local anaesthetic paste is placed along the length of the marked vein and covered with plastic and warm beanbags are applied which help to dilate the vein for access. If you are anxious you may wish to breath on an inhalational medicine called Penthrox that can help to calm you and make the entire experience more comfortable. This agent is very safe and is used in ambulances and emergency situations. It has been shown to be very safe in adults and children in the doses used.

After 30 minutes you are transferred to the laser room where your leg is washed with an antiseptic solution and draped to create sterile conditions.

Using the ultrasound probe the main saphenous trunk can be seen and accessed with a needle and wire. The laser fibre is then inserted into the vein under ultrasound guidance and positioned so that when it is turned on the saphenous trunk will be closed along the planned length.

Local anaesthetic is then injected into the thigh around the vein to anaesthetise the leg and also provide an area where heat can dissipate to avoid injury to the tissues surrounding the vein. This is called Tumescent anaesthesia. The laser is then activated and withdrawn along the saphenous trunk using an automatic device that has the effect of shutting the vein.

After removal of the laser probe, ultrasound guided sclerotherapy and/or surface sclerotherapy is usually performed to treat the branch veins. The leg is then bandaged and a class 2 compression stocking applied. The patient is then free to be discharged home with an adult companion.

The entire procedure takes approximately 30 to 45 minutes. The stocking and bandage stay in place for 48 hours and then the bandages can be removed and the stocking replaced and worn day and night for the next week. You will then return for an ultrasound examination to make sure that the laser treatment has been effective and to monitor the progress of the healing veins.

The advantages of the Cool Touch endovenous laser treatment as opposed to conventional surgery are    

1. No scarring.
2. No cut in the groin.
3. Less bruising.
4. Faster recovery
5. Can be done under local anaesthetic.
6. No overnight hospital stay needed.

There are other laser treatments for varicose veins and these are effective as well. There appears to be a difference with the CoolTouch CTEV 1320 nm laser in that it causes less bruising. This appears to be because the laser energy is absorbed by the water of blood and there are fewer ruptures of the main saphenous trunk when using this technology. With other laser systems there may be a taste of charcoal in the mouth from boiling of the blood which is the target for different wavelengths of laser energy used in those situations. This occurs in about 10% with the Cool Touch system. With fewer micro perforations of the vein using the CoolTouch system there appears to be less bruising and less pain and faster recovery than other laser treatments.