Endovenous Laser Ablation

Endovenous laser ablation, also known as EVLA, is a minimally invasive alternative to the traditional ligation and stripping treatment of varicose veins. Varicose veins are a common medical condition involving diseased veins, usually in the leg. As blood pools in the legs, the walls of the veins distend, until the veins appear raised and twisted under the skin. For some individuals, varicose veins present only a cosmetic problem. If the condition worsens, however, varicose veins can become painful and even dangerous and medical intervention may become necessary.

The Reasons for an EVLA

Varicose veins result from weakened valves in the veins which permit the blood to flow backward instead of back to the heart. This back flow is called venous reflux. Venous reflux results in pooling of the blood in the legs, causing a variety of symptoms. These symptoms may include:

  • Unsightly swelling and distension along the affected veins
  • Pain which becomes more severe with sitting or standing
  • A sensation of heaviness in the legs
  • Bleeding, discoloration and ulceration along the vein's path

Patients with small spider veins may not be candidates for EVLA alone and may require sclerotherapy as well.

The Benefits of an EVLA

EVLA is a relatively new technique for treating varicose veins. It is minimally invasive, using laser energy to heat damaged veins and seal them shut. EVLA is considered preferable to traditional surgery which involved ligation and stripping of veins. Unlike stripping procedures which result in many scars and a lengthy recovery period, EVLA involves only a short, outpatient procedure with no general anesthesia and offers the following benefits:

  • Small single incision with no suturing or scarring
  • Successful removal of damaged veins
  • Little pain or discomfort
  • Very short recovery period

Most patients experience Immediate relief from symptoms after the EVLA procedure.

The EVLA Procedure

During the EVLA procedure, the skin is numbed with local anesthesia, and a tiny laser fiber is inserted into the skin and guided to the saphenous vein through ultrasound imaging. The saphenous vein is the large superficial vein carrying blood from the lower body back to the heart. Once the laser fiber is inserted, the vein is surrounded by a small amount of liquid and exposed to the laser energy. The laser energy causes the vein to be sealed off and diverts blood flow to healthier surrounding veins. The whole procedure usually takes less than an hour to perform. Blood flow may actually be improved by EVLA since the presence of the damaged vein is likely to have made the other veins work harder than usual.

The Risks of an EVLA

While EVLA is considered to be a very safe procedure with a low incidence of complications, there are certain risks associated with this procedure. These risks may include:

  • Infection
  • Thrombophlebitis
  • Deep vein thrombosis
  • Nerve damage
  • Burns to the skin

Bruising is common after the procedure, but it is usually mild and resolves in a week.

Recovery from an EVLA

After the EVLA procedure, patients are able to return home and resume normal activities the very next day. They are cautioned to avoid strenuous activity for a few weeks. While some pain is to be expected after EVLA, such pain is usually mild and short-lived, responding well to over-the-counter pain medications. Compression stockings should be worn for about a week after the procedure to lessen swelling, bruising and discomfort.

During and after recovery, patients are encouraged to live a healthy and active lifestyle in order to maintain the positive results and to prevent vascular damage in the future.

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