Endovenous Laser Ablation
Endovenous Laser Ablation

What is endovenous laser ablation?

Also called EVLA or EVLT, endovenous laser ablation is a minimally-invasive procedure that uses lasers to shrink varicose veins, precisely damaging the lining of veins so blood flow is prevented. EVLA uses a very thin fiber that’s inserted through a tiny opening in the affected vein. As the fiber is carefully advanced through the damaged vein, it fires off a controlled “stream” of laser energy, creating controlled damage to the vein lining. EVLA is typically performed in conjunction with ultrasound technology, which is used to track the location of the fiber to ensure the laser energy is targeted with utmost precision for greater accuracy and optimal results.

When is endovenous laser ablation performed?

EVLA is used to treat varicose veins in your legs, including the great saphenous vein (GSV) and the small saphenous vein (SSV), two large superficial veins located not far below the surface of the skin. The two GSVs are the longest veins in the body, running the length of each leg. EVLA reduces or eliminates the purplish, bulging appearance that occurs when these veins become varicosed, and it also reduces or eliminates other symptoms like tingling, pain, burning, itching and numbness that occur when these veins become damaged.

What happens during endovenous laser ablation?

EVLA is performed as an outpatient procedure, typically taking well under an hour to perform, with the actual laser treatment only taking a few minutes. Before your procedure, your vein will be carefully mapped using ultrasound technology so the treatment area can be clearly and precisely defined. The area will be anesthetized with a local or regional anesthetic, without need for general anesthesia and the risks it can convey.

After the area is numbed, a very small incision will be made into the vein to allow the thin, flexible fiber to be gently inserted. Ultrasound will be used to carefully guide the fiber into place. Once the fiber reaches the target treatment zone, tiny bursts of laser energy will be fired along the length of the damaged vein, causing controlled damage and scarring to encourage the vein to “close up,” preventing the flow of blood over time. Instead, blood flow will be “re-routed” to neighboring veins with no detriment to circulation.

Once the procedure is complete, the incision site will be bandaged with a special dressing that eliminates the need for sutures and significantly reduces the chance of developing any noticeable scarring.

How will I feel after EVLA treatment?

Since the procedure is minimally invasive and requires no large incisions, recovery is quick, and most patients can return to most normal activities immediately following their treatment. Mild bruising and swelling may occur in the treatment area, but both will resolve soon afterward. Any minor discomfort can be treated with over-the-counter pain medications. Compression hose may be prescribed for generally up to three weeks to help speed healing.

This procedure is performed by our Interventional Radiology team at our affiliated hospitals.

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