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Laser ablation for varicose veins (EVLA)

Endovenous ablation of varicose veins uses energy to cauterise (burn) and close varicose veins. It is used to help ease symptoms such as pain, swelling, and irritation. Laser energy is used to heat the vein in order to destroy it. EVLA is safe, less invasive than surgery, and leaves virtually no scars.  

A fine tube (catheter) is passed through the skin near the knee and then threaded up the diseased long saphenous vein. The catheter is attached to a laser that heats the end of the catheter. The heat seals the walls of the vein so that no blood can flow through it. The operation can be done under general or local anaesthetic. We normally use local anaesthetic, since this allows a more rapid recovery after treatment.

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How is EVLA different to surgery treatment?

Varicoe vein surgery usually requires a cut in the groin to tie off the vein, after which it is removed by a stripping device. This can cause significant bruising. EVLA avoids the need for a cut in the groin and there is minimal bruising, so people who have EVLA can usually return to normal activity sooner than those who have standard treatment.

Is EVLA better than surgery?

The main advantage of EVLA is, that after the operation there is very little discomfort and bruising compared to conventional surgery. In the long-term an excellent cosmetic outcome can be expected from either technique. There is a similar risk of recurrence following either procedure.

Can I have EVLT?

Is everyone with varicose veins able to have EVLA?

No. Some people have large, winding veins, that are not suitable. Recurrent varicose veins after previous surgery are often unsuitable for EVLA. We will be happy to arrange a consultation to discuss whether your veins are suitable for EVLA. About 70% of people with varicose veins can be treated with EVLA.

Is EVLA all I need for my veins?

EVLA will remove the major superficial veins, including the LSV and anterior thigh veins. It is, however, usually necessary to have the bulging veins around the calf removed. We usually treat these veins with foam injections at the same time as the EVLA treatment.


Alternatives, pre and post treatment advice

What are the advantages of EVLA?

Apart from the lack of a cut in the groin, there is minimal bruising of the leg and people can return to normal activities quickly.

What is the catch?

EVLA uses special catheters as well as ultrasound imaging during the operation. This leads to increased costs compared to foam sclerotherapy.

Why do some surgeons not offer EVLA?

There may be many reasons. Some surgeons may not have been trained to use EVLA, they may prefer an alternative technique like RF ablation, or they may feel the operation takes longer than traditional surgery. If your surgeon does not offer a treatment that you have read about, they should be able to give a reasonable explanation.

Are there any complications associated with EVLA?

There is a small risk of burns to the skin and possibly a slightly increased risk of deep vein thrombosis (DVT), as with all treatments for varicose veins. Some patients, who have had EVLA, experience an odd sensation or sensitivity in the thigh. This tends to start about 3 to 5 days after treatment. The sensation disappears in most people within a few weeks. Very rarely (a 1 in 200 chance) the discomfort can last longer and be more intense. This can also occur with traditional surgery and laser treatments.

Will my insurance company pay for EVLA?

Most insurance companies will pay for this treatment, but you will need to consult your insurance company prior to starting the treatment.


Alternatives, pre and post treatment advice

Are there any alternatives to EVLA?

The least invasive method of treating varicose veins is ultrasound guided foam sclerotherapy. If you would like to avoid surgical treatment, this is a further possibility. A technique, using an RF catheter to heat the blood in the long saphenous vein, is available in some centres.

How is this treatment given?

EVLA is performed in a treatment room or operating theatre under local or general anaesthesia. An EVLA catheter is threaded along the vein under ultrasound guidance. Local anaesthetic is injected around the vein. Electrical heating is used to destroy the vein as the catheter is withdrawn. Varicose veins are removed through tiny cuts in the leg or injected.  

What does the treatment feel like?

Under local anaesthetic only very minor discomfort is felt.  

Compression regime

Following treatment, we apply a firm compression stocking to the leg, which should be worn for 1 week.

Effects of treatment.

Most patients are able to leave the clinic immediately after treatment. Some discomfort or numbness may be felt in the leg.

What is it like afterwards?

Immediately after the EVLA treatment patients are able to walk normally and continue their daily routines. Vigorous exercise should be avoided for the first week. The leg may ache initially and this can continue for 2 – 4 weeks, but is not troublesome. Some patients need to simply take pain killers for this.

Travel after EVLA

If your treatment has been performed under general anaesthetic, we recommend that you avoid long-haul air travel for 4 weeks. For patients treated under local anaesthetic we suggest, avoiding long-haul air travel for at least one week following treatment. Journeys of less than 4 hours need not be restricted.

Further sessions

Any varicose veins, which remain after treatment, can be managed by a session of injections. Your specialistconsultant would like to check that the treatment has worked and treat any remaining varicose veins one or two weeks, following the main treatment.

Call any of our vein clinics for an appointment. You should contact your consultant for advice, should any other matter arise in connection with your treatment.

EVLA may result in the development of thread veins in the region of treatment in susceptible people. These may be treated by microsclerotherapy, if necessary.

Contact us

Contact us

0800 7836106

24-28 The Broadway
Amersham, Buckinghamshire
0800 7836106
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The Bridge Clinic
Maidenhead, Berkshire
0800 7836106
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62 Wimpole Street
0800 7836106
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Suites 509-510
Q House, 76 Furze Road
Sandyford, Dublin 18
Dublin 01-2937 839
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