Endovenous Laser Ablation (EVLA)
What is Endovenous Laser Ablation?
Endovenous Laser Ablation Treatment EVLA is predominantly used to treat the Large and Small Saphenous Veins (trunk of the tree) previously treated by surgical ligation and stripping in hospital under general anaesthetic.
Other large veins including the Anterior Accessory Vein or large perforators can also be treated.
It is the most common alternative to surgical vein stripping of large malfunctioning veins and is the preferred method for varicose veins larger than 6mm in diameter.
Varicose veins are not removed from the body so there is less trauma, discomfort and recovery time required.
Before and After
What to expect when having Endovenous Laser Ablation
- Photos of your legs will be taken prior to treatment.
- You will be measured for medical grade compression stockings which must be worn post treatment for up to 7 days.
- With ultrasound guidance and through a series of small injections,local anaesthesia will be used to numb the area around your vein.
- If additional pain relief is required, your clinic offers both Penthrox (green whistle) and Entonox (laughing gas)
Note: If you require this form of additional pain relief, you will be required to have someone drive you home. - Your Dr will make a small incision in your leg, usually below your knee or near your ankle. Through this incision and with ultrasound guidance, the laser fibre is then fed into your abnormal vein The Doctor will activate the laser to generate heat. This produces a reaction in the vein wall along the treated section, resulting in collapse and sclerosis of the vein wall, permanently sealing off the vein.
What to expect post Endovenous Laser Ablation
- You will be required to wear your medical grade compression stockings for a min of one week. The first 4 days, you must not take off your compression stockings. This means, even showering in them. The following 3 days, you can take your compression off to shower, but you must wear them during the day. You may sleep without your compression if you so desire.
- Note, your legs will look ‘worse’ before they look better.
- Avoid excessive sun exposure to treated areas for at least one month after treatment. This can cause hyperpigmentation.
- Avoid strenuous activities or high-impact workouts for one week after treatment.
- DO NOT take any hot baths, showers or sit in any hot tubs for one week after treatment.
- DO NOT be overly sedentary during your recovery.
- You will be requested to take 2 daily 30min walks of one week post treatment.
Frequently Asked Questions
What is Endovenous Laser Ablation (EVLA)?
Endovenous laser ablation (EVLA) is a method of treating veins that cause varicose veins by inserting a laser fibre into the vein and heating the vein internally. This leads to the vein collapsing and shutting down from the inside. The vein is then absorbed by the body over several months without needing to be surgically removed.
What are the benefits of laser treatment?
With initial success rates of almost 100% and 5 year success rates of >95%, EVLA is the gold standard method of treating the underlying veins that cause varicose veins.
As the vein is not physically removed from the body (unlike traditional surgery) there are no scars, and the recovery time is much faster, and time off work for recovery isn’t necessary. Bruising and pain is also very minimal after treatment.
The treatment is performed as a “walk-in, walk-out” clinic-based treatment. There is no need for hospital admission or general anaesthetic.
How can I prepare for the EVLA procedure?
Do NOT apply moisturiser to your legs on the day of treatment.
On the day of the procedure, you are fine to breakfast and take your regular medications as per usual unless otherwise instructed.
Dress in comfortable loose-fitting and dark clothing when coming to your appointment.
Arrange transport to and from your appointment and let us know if you are anxious and would like a pre-med.
Trial your stockings ahead of time to ensure they are a suitable fit, this is particularly important if you are overweight.
How long does the procedure take?
Roughly 1 hour overall from the time you enter to the time you leave the clinic. The laser treatment is quite quick and takes less time than other stages. Other stages include blocking the nerve, administration of anaesthetic, and bandaging of the leg afterwards.
Is the laser dangerous?
The EVLA treatment is extremely safe in the hands of a well-trained and experienced professional like Dr Thomaz Silva.
The laser beam can harm the eyes if looked at directly. Therefore, everyone in the procedure room wears special safety glasses during the laser phase of the procedure, in order to protect the eyes in the unlikely event of an equipment malfunction.
Can the veins come back?
- No matter how good the treatment is, new veins can develop around 3% per year. Our comprehensive aftercare program involves an annual scan to check for any new abnormal veins and monitor the treated vein. This means we can catch any recurrence early, before it becomes a problem, and treat it with a simple sclerotherapy injection. It is important to keep up with your aftercare by visiting the clinic annually so that your EVLA treatment is maintained over time.
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