Endovenous Laser Ablation for Varicose veins
EVLA or EVLT for Varicose Veins. Endovenous laser ablation, also referred to as EVLA or EVLT is the most effective treatment for varicose veins. EVLA was pioneered by Dr Robert Min in the USA and is now the most widely used form of treatment for varicose veins in the USA, Australia and New Zealand.
A laser fibre is introduced into the saphenous vein through a very small needle hole in the skin. The fibre is then progressed to the junction of the abnormal varicose vein and the deep vein system. The saphenous vein is then surrounded by a special type of local anaesthetic called tumescent anesthesia which completely numbs the area around the vein and protects the surrounding tissue from the heat of the laser. The laser is then turned on and slowly withdrawn which instantly cauterises and seals the vein.
There is an initial inflammatory reaction to the cautery which leads to effective closure of the vein in almost 100% of cases. The procedure is walk in walk out taking about 30-60 minutes for one or two legs. Because the laser cannot be used on the very tortous parts of the vein the EVLA treatment is often combined with UGS, an injection technique.
Prior to EVLT a comprehensive ultrasound map is performed so that all abnormal veins can be targeted by the treatment.