You may have heard about Endovenous Laser Ablation (EVLA), or Endovenous Laser Therapy (EVLT). What exactly does it mean?
- ‘Endovenous’ means ‘inside the veins’
- ‘Laser’ is heat energy transmitted by light
- ‘Ablation’ means to ‘destroy’
Therefore, Laser Ablation literally means to destroy veins from the inside with laser. It is an advanced technique that uses heat from a laser to seal off varicose veins and prevent the flow of blood. Below are 10 key facts about Endovenous Laser Ablation (EVLA). This article explains why it is the treatment of choice for both physicians and patients.
10 Key Facts About Endovenous Laser Ablation (EVLA)
1. EVLA is not a surgical procedure
EVLA offers many advantages over vein stripping. mostly, it is minimally invasive and non-surgical. Therefore, it offers patients immediate results with no hospital stay and minimal downtime.
This means no general anaesthesia. Also, the type of local anaesthetic we use is “tumescent anaesthetic”. We inject it around the vein area with the help of ultrasound imagery. This makes the entire procedure extremely comfortable and virtually painless for patients.
2. Laser for varicose veins works by damaging the vein walls up to 1200 degrees celcius!
If you end up having laser treatment your doctor will select the most appropriate laser for your treatment. Some endovenous lasers are more likely to hurt more than others (after the treatment) and are known as bare tip laser fibres. These older fibres fire in one direction and so their energy is focused. This is in contrasts to radial laser fibers which are more likely to fire in a circular manner, meaning a smoother sealing effect on your varicose veins.
3. EVLA has a 98% success rate
Indeed, Endovenous Laser Ablation works effectively on 98% of all patients, requiring only one treatment. And it is quite unusual for patients to come back for a second treatment.
4. EVLA treatment for varicose veins is considered safe
Laser treatment, specifically EVLA, is fundamentally safe. There are risks with any medical procedure and with EVLA, bruising or a burn to the skin are possible. Complications leading to nerve damage, a blood clot, or deep vein thrombosis (DVT) are also possible however, the risk of these more serious complications is very slim ( <1%).
5. EVLA isn’t suitable for all veins or patients
Endovenous Laser Ablation is best for large and uncomplex varicose veins that have started causing symptoms of pain, itching, or swelling. These include the larger “trunk” leg veins including:
- Great Saphenous Vein (GSV)
- Small Saphenous Vein (SSV)
- Their major tributaries such as the Anterior Accessory Saphenous Veins (AASV)
Its laser fibre, while flexible, is difficult to manoeuvre around tiny, twisted surface veins – a job better suited for sclerotherapy. On that note, laser also isn’t advised for more sensitive areas (like the vulva or scrotum),
Specialists also don’t advise laser treatment for pregnant people or for those on HRT, as the treatment poses additional risks. If you are on HRT, you are at a slightly higher risk of clotting, so be sure to consult your doctor on how best to proceed.
6. It’s based on a thorough ultrasound process
The treatment plan includes a duplex ultrasound to map out your veins. Also, the scan creates a visual map of your circulatory system. That in turn lets doctors know how well your venous network and blood flow are functioning. The ultrasound images are similar to what you would see during a baby scan, except that we perform this one on your legs. This way, the scan can reveal important information such as which valves are refluxed (faulty), and if any clots are present. It helps doctors determine an optimal course of action specifically for your condition.
7. You’ll feel a stinging pain – but not because of the laser
During your procedure, you’ll have an anaesthetic procedure known as tumescent anaesthesia performed on your leg. This is the difficult part of the procedure but also a really important one. Using a pump or manual syringe your doctor will inject very dilute local anaesthetic around the laser so that when it’s switched on there’s no pain. Local anaesthetic can often sting and this will often be mild but in some patients < 5% the procedure may need to be delayed. It’s rare that you actually feel any pain when the laser procedure is being performed.
8. EVLA reroutes blood flow through other healthy veins
During a Laser Ablation EVLA/EVLT treatment, your doctor inserts the laser fibre into the vein that needs treatment. As the laser heats up slowly, it causes controlled damage to the vein walls. Eventually, the vein shrinks, the body absorbs it and it disappears. Then, the body directs the flow of blood through other healthy veins, re-establishing proper blood flow.
9. Laser procedures take less than 45 minutes
The exact treatment time depends on the size of the area that needs treatment. We can treat both legs during the same visit. We will ask you to wear a compression garment for one week to facilitate the healing process. Also, it is normal to experience minor discomfort such as itching and sensitivity for a couple of weeks post-procedure.
10. You may feel sore after EVLA
Common treatment side effects include bruising, swelling, and some achiness around the sealed vein. To minimise these, we recommend walking immediately after treatment, drinking plenty of water, wearing compression wraps and stockings, and avoiding certain activities. If you still feel discomfort, you can take over-the-counter pain relief containing ibuprofen. While you can resume most activities right after your treatment, you should still avoid strenuous exercise such as running and working out at the gym for 3-5 days post-procedure.
Seek expert advice
The doctors at The Vein Institute specialise in varicose vein treatment. Also, we offer patients a comprehensive treatment program to treat varicose veins, with non-surgical laser treatment techniques. To book a consultation and discuss our treatment program, call 04 2010 2637 or make an enquiry via the Contact Us page.