The Vein Institute

Endovenous Laser Ablation (EVLA) — Laser Treatment for Varicose Veins

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What Is Endovenous Laser Ablation (EVLA)?

Endovenous laser ablation (EVLA) is a minimally invasive laser treatment for varicose veins. During the procedure, we make a tiny incision and feed a thin laser fibre into the vein. The laser located at the tip of the fibre works at a frequency ranging from 810 to 1470 (nm). The intense heat causes the blood in the vessel to clot, sealing the vein and stopping blood flow. As we use a regional anaesthetic, you should not be able to feel this happening. Over time, the varicose vein fades, and your body will reroute blood flow through other healthy blood vessels.

Over the past decade, this procedure, along with Radiofrequency ablation (RFA), has emerged as a gold standard treatment for varicose veins in the feet and legs due to its high success rate, short recovery time and minimal discomfort. During the procedure, your doctor is likely to use a local anaesthetic to numb a nerve to make the procedure more comfortable. We have found that our patients get the best results when we combine it with sclerotherapy.

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Why do we use Endovenous Laser Ablation at The Vein Institute?

  • Specialists consider EVLA to be the gold standard of varicose vein treatment.
  • It is a minimally invasive (i.e. non-surgical) procedure to treat venous insufficiency.
  • It’s considered safer than surgical stripping and has a success rate of 92-94% over 5 years..
  • Specialists can perform it in 30–60 mins, with few side effects.
  • Superb advances in technology and equipment for optimal results.
  • The body gradually absorbs the vein and reroutes blood to other vessels.
  • Patients experience minimal discomfort with the help of a local anaesthetic..
  • Some doctors will utilise a local anaesthetic to block a nerve known as regional anaesthesia (your walking will not be affected) to provide more comfort.

What are the differences between EVLA and Radiofrequency Ablation?

Although the differences between radiofrequency ablation and endovenous laser treatment for varicose veins are minimal, our experts may decide one is preferable over the other, depending on the patient.

For example, EVLA tends to be better suited for patients whose veins are larger in diameter or if blood clots are present. For other patients, RFA is the better choice because it often results in less discomfort and bruising and has a lower risk of complications overall.

Why is ultrasound used in EVLA treatments?

Ultrasound imagery is an integral component of laser treatment for veins because it helps doctors guide the laser fibre through the vein. It essentially creates a picture of your vascular network and allows the doctors to see what’s happening inside your body and where to pull the fibre for the best results.

What to expect during the laser procedure for varicose veins

  • A nerve block with local anaesthetic (regional block) in the mid-thigh may be performed before the procedure to provide more pain relief.
  • Your doctor will then numb the area where the laser will enter with a local anaesthetic and make a tiny incision.
  • They will use ultrasound imaging to reveal the problem vein and its path throughout your lower limb.
  • They will then insert a thin fibre into the vein through the tiny incision, using ultrasound to guide the fibre along.
  • Following that, they’ll apply a more dilute local anaesthetic around the vein before engaging the laser fibre. After engaging the active laser fibre, they will slowly withdraw the laser under ultrasound along the course of the vein.
  • Finally, they’ll cover the incision site with a bandage and apply pressure. As the incision is small, we won’t need to apply sutures or stitches.

How to prepare for your EVLA treatment

  • Make sure to eat before your EVLA treatment. Like with a blood test, coming in on an empty stomach could make you feel faint. 
  • Drink plenty of water (at least 2 glasses, or 500 ml) within an hour of your treatment. Being well-hydrated will reduce the risk of clotting and minimise post-treatment symptoms like swelling and pain.
  • You should wear loose-fitting pants because your legs will be wrapped with elastic bandages after the procedure.
  • Lastly, avoid shaving your legs the morning of the treatment.
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Laser ablation post-op care

You’ll be allowed to go home almost immediately after the varicose veins laser treatment. To help with your recovery, you’ll need to drink plenty of water and wear the compression wraps that we provide continuously for 24 hours and special compression socks for a further 3 – 5 days (daytime only). You will also need to walk a minimum of 30 minutes each day for 2 weeks after treatment. These steps can help minimise swelling and reduce discomfort.

What are the risks of EVLA?

Endovenous laser ablation is a very low-risk procedure. You may experience some bruising and discomfort for a few days to weeks, but it should not impact your daily life.

Potential side effects include a very low risk of deep vein thrombosis (approx. 0.1%), transient nerve sensation changes (approx. 0.5%) and minor skin or infection issues (exceptionally rare). Severe systemic reactions to local anaesthesia also remain exceptionally  rare.

Want to learn more? Read our post about the 5 things to know before laser treatment for varicose veins.

Before and after laser ablation for varicose veins

Following your treatment, you’ll see a 60–80% shrinkage of the veins. You’ll also likely notice a reduction in symptoms. However, in some cases patient recovery maybe delayed owing to the necessity of treating large branch veins. In most cases by month 2 the treated varicose veins are well on the way to healing.

To see more before and after varicose vein treatment photos, click here.

To see more before and after varicose vein treatment photos, click here.

Have Questions about Endovenous Laser Treatment for your veins?

We have listed some of our most asked questions below regarding laser for varicose veins. If you would like to speak to someone, please contact us on 04 2010 2637 or make an appointment.

How long does the procedure take?

Our doctors usually perform endovenous laser ablation in around 45 minutes. We can do it so quickly because we use regional anaesthesia, we will not need to make any large incisions, and we do this treatment frequently.

How much does Endovenous Laser Ablation (EVLA) treatment cost?

Endovenous laser ablation (EVLA) treatment at The Vein Institute ranges from $3,200 to $4,200 (out-of-pocket), depending on the complexity of your varicose veins, if you’ll need one or both legs treated and how much of the cost Medicare covers. Review the costs for our varicose vein treatment plan. Endovenous laser ablation will always include some form of ultrasound and anaesthesia in addition to the cost of the procedure.

What are the possible complications of Endovenous Laser Ablation (EVLA) treatment?

Although quite rare there exists the possibility of a deep vein clot (1:1000) a temporary nerve injury (and subsequent numbness, tingling or pain below the knee 1:200) or a skin burn(<1:1000). However, the risk of such complications is extremely very low owing to the high volume of cases performed by the treating doctors. Our doctors are qualified and experienced medical professionals.

What is recovery like after EVLA?

Recovery following endovenous laser treatment for varicose veins can vary between individuals. Many patients may be able to stand and walk soon after the procedure, and light daily activities are often resumed relatively quickly.

Your doctor may advise wearing compression stockings for a period of time and maintaining gentle walking throughout the day to support blood flow. Recovery guidance will always depend on your individual treatment plan and medical history.

Is endovenous laser treatment painful?

A regional and local anaesthetic is typically used during laser treatment for veins, so the treatment area is numbed while the procedure is performed. Some people notice mild sensations such as tightness, tenderness or minor bruising along the treated vein afterwards. These effects usually settle as the area heals. Your doctor will explain what to expect following varicose veins laser treatment and when to seek advice if needed.

What should I avoid after endovenous laser ablation?

After endovenous ablation, your treating doctor may recommend temporarily limiting certain activities. This can include avoiding heavy physical exertion, prolonged periods of sitting or standing and environments with high heat, such as spas or saunas.

Regular walking is often encouraged because it helps support circulation. Your clinician will provide instructions tailored to your treatment and recovery.

Who is a good candidate for endovenous laser treatment?

People experiencing symptoms from varicose veins affecting specific leg veins may be considered for laser treatment for varicose veins. Diagnosis usually involves a medical assessment and ultrasound imaging to evaluate blood flow and vein structure. This assessment helps determine whether endovenous laser ablation or another treatment option is the most appropriate approach or whether a conservative approach is preferred.

Can EVLA treat all varicose veins?

Endovenous laser treatment is designed to treat particular types of veins, most often larger underlying veins that contribute to visible varicose veins. Smaller surface veins may be managed with treatments such as sclerotherapy, while other cases may require alternative procedures.

Your doctor will discuss the most suitable treatment strategy based on the characteristics of your veins and your symptoms.

EVLA vs other treatments: which is best?

There are several ways to manage varicose veins, and laser treatment depends on factors such as vein size, location and overall vascular health.

 

Endovenous laser ablation and radiofrequency ablation (RFA) both treat veins internally by applying controlled heat to close the affected vessel. Other techniques include medical adhesive closure, which seals the vein with a specialised glue, and sclerotherapy, where a solution is injected to collapse smaller veins, such as spider veins.

If you would like to explore these options further, our guide comparing endovenous laser ablation treatment, RFA and other approaches explains how each procedure works and when it may be considered.

Make an Informed Decision

You should not consider any medical procedure without due diligence. Also, this is why all our patients undergo an initial consultation with one of our doctors. During this consultation, an ultrasound scan of your legs is taken. This gives us a thorough understanding of the severity of the varicose veins. Also, this allows the doctor to prescribe the most suitable treatment program.

After your first consultation, you will have all the information you need to make an informed decision as to whether or not the treatment program is suitable for you and your circumstances.

Book your EVLA appointment at The Vein Institute today

If you are exploring laser treatment for varicose veins, the first step is a professional medical assessment. Our team can evaluate your vein health and determine whether endovenous laser treatment or another option may be appropriate.

To book your first consultation at our Sydney clinic and to discuss our treatment program, call 04 2010 2637 or contact us to receive a callback from us.

Read more:

Is it Worth Treating Varicose Veins?

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