Varicose Veins Therapy
Dr. Lisa Perez Dr. Lisa Perez

Endovenous Laser Ablation for Varicose Veins

What is EVLA and how is it different from sclerotherapy?
Endovenous Laser Ablation or EVLA is a minimally invasive technique that can bring immediate relief from the symptoms of varicose veins. The procedure usually takes less than an hour and uses laser energy delivered in a thin fiberoptic probe. The difference between EVLA and sclerotherapy is that EVLA is aimed at treating larger veins using laser energy, while sclerotherapy involves a series of small injections of a solution into smaller more superficial veins.

Who is a good candidate for EVLA?
Any patient that suffers from varicose vein disease and is in good general health is a good candidate for EVLA. Patients that are pregnant or have a history of DVT (deep vein thrombosis) are not. Patients should be thoroughly evaluated by a physician and require an ultrasound to determine if EVLA is the best treatment option for them.

How is EVLA performed?
EVLA is a 45 minute procedure where a catheter is inserted into the defective vein. The procedure is done under local anesthesia using ultrasound guidance.  A laser is threaded into the catheter and heats the lining of the vein. Then it is slowly pulled out of the vein, damaging it and causing it to shrink and seal shut.  Once this happens, blood can no longer flow through the vein. This eliminates the pressure in the vein that caused it to bulge. There is no incision other than a small puncture where the catheter was inserted.

What are the risks associated with EVLA?
Complications from EVLA are extremely rare. These may include numbness and tingling over the treated area, skin infection at the puncture site, DVT (deep vein thrombosis or blood clot which is rare) and phlebitis, which is redness, warmth and swelling of the treated vein. To minimize any risk associated with EVLA, we encourage patients to walk a lot after the procedure, wearing compression stockings and following up with a post procedure ultrasound.

What is the recovery time?
Patients are immediately able to get up and walk following the procedure. They may experience some mild soreness, redness and bruising in the week following the procedure, but this is usually resolved by the end of the second week. Some patients may also feel a pulling sensation or tightness in the calf or thigh, but this is normal and soon passes as well. These symptoms can be managed by taking a non-aspirin anti-inflammatory for a few days following the procedure. Compression stockings are also required for a week or two following EVLA. This helps reduce swelling, protects against blood clots and speeds up the recovery process. After the procedure, walking and normal daily activities are encouraged. Rigorous exercise such as running, high impact aerobics and heavy weightlifting should be avoided for a week or two to get the best possible results from the procedure.

How successful is EVLA?
Patients enjoy a 98 percent success rate after undergoing the EVLA procedure.