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The Vein Institute

Endovenous Laser Ablation

Introduction

Endovenous laser ablation (EVLA) is a minimally-invasive treatment for varicose veins. Over the past decade, this procedure, along with Radiofrequency ablation (RFA) have emerged as the gold standard treatments, due to their high success rates, short recovery times and minimal discomfort for patients. We have found our patients get the best results when it is used in conjunction with sclerotherapy.

EVLA involves inserting a catheter into the vein then delivering a source of heat, closing off the vein and stopping the flow of blood. A laser located at the tip of the catheter is inserted into the varicose vein. It works at a frequency ranging from 810 to 1470 (nm). The intense heat causes the blood in the vessel to clot, thereby sealing the vein and halting blood flow. The patient should not be able to feel this happening. Over time the varicose vein fades and blood is rerouted through other healthy blood vessels.

Why do we use EVLA at The Vein Institute?

  • EVLA is considered the gold standard of varicose vein treatment
  • It is a “minimally invasive” procedure to treat venous insufficiency
  • Safe procedure and high success rates
  • Quick outpatient procedure (30-60 min) with few side-effects
  • Superb advances in technology and equipment for exceptional results
  • Diseased vein is gradually absorbed by the body and blood rerouted to other vessels
  • Patients experience minimal discomfort with the help of local anaesthetic

Differences between EVLA and RFA

Although the differences between the two procedures 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 may be the better choice because it tends to result is slightly less discomfort, bruising, and has a lower risk complications overall.

Importance of Ultrasound during EVLA

Ultrasound imagery is an integral component of EVLA because it helps doctors guide the catheter through the vein. It essentially creates a picture of your vascular network and allows the doctors to see what’s happening inside your body. It can also reveal blood clots or a condition known as deep vein thrombosis (DVT).

What to expect during the procedure

  • Your doctor will numb the area where the catheter will enter with local anaesthetic
  • Ultrasound will be used to reveal the problem vein and its path throughout your body
  • A catheter will be inserted into the vein through a tiny incision, using ultrasound guidance
  • Laser energy will be used to heat the vein, and seal it shut, as the catheter is slowly removed
  • The incision will be covered with a bandage and pressure will be applied. No sutures or stitches needed.

Post treatment

You’ll be allowed to go home almost immediately after your procedure. To help with your recovery, you’ll be asked to wear the bandages provided continuously for 48 hours, and special compression socks for a further 3 – 5 days. You will also need to walk a minimum of 30 minutes each day for 2 weeks after treatment.

Endovenous laser ablation is a very low risk procedure. Patients may experience some bruising and discomfort for a few days to weeks but it should not impact your daily life. Although complications with EVLA are extremely rare, there are some potential side-effects including, deep vein thrombosis (1% risk), nerve injury and skin burns.

Have Questions About Endovenous Laser Treatment for your Veins?

We have listed some of our most asked questions to the right. If you would like to speak to someone please contact us on 1300 535 017 or make an appointment.

What can I expect during treatment?

  • After your scan at our clinic your leg will be cleaned before a tiny amount of anaesthetic is applied (using super fine needles).
  • A catherer is inserted into the vein and the Endovenous Laser fibre is inserted.
  • After this a cool anaesthetic is then applied around your vein to protect surrounding tissues.
  • You will then be required to wear goggles before the laser machine is switched on.
  • During the procedure the laser will be pulled back to seal the faulty vein. Rarely will patients experience any discomfort when the laser is being used.
    After the procedure you will be required to wear stockings for 5-7 days and walk half an hour a day.
  • Long distance travel is not permitted for 4 weeks.
  • Your leg may feel numb for six hours after the procedure.
  • A follow-up appointment is required for all patients. At this appointment further treatment may occur with ultrasound guided sclerotherapy.
  • Learn more about what to expect here.

How does Endovenous Laser Ablation work?

In this procedure the laser energy closes the vein wall and seals of the faulty vein. The closed vein eventually disappears as the body reabsorbs it over time.

 

 

 

How does blood get back to the heart if the vein is damaged?

When your veins become varicose veins, they no longer pump blood effectively back to the heart and are not responsible for your circulation. As everyone has billions of veins, the blood naturally finds its way to the heart using other veins.

Are there different laser types?

There are many different laser types each with their own specific uses. The Vein Institute uses the latest radial tip laser fibres. They are used as it is reported that patients experience less pain after the procedure compared to traditional bare tip laser fibres.

Do I need to prepare for the procedure?

  • If your procedure is scheduled for the morning, be sure to eat breakfast and take any normal medications.
  • You should wear loose-fitting pants because your legs will be wrapped with elastic bandages after the procedure.
  • Avoid shaving your legs the morning of the treatment.

Can I drive after the procedure and what must I do?

  • Yes you can drive after the procedure (if you have not taken any medication for anxiety).
  • However no long distance travel > 5 hours is recommended. If this is necessary you are required to have an injection of Clexane.
  • All patients must wear stockings overnight and for up to 3 days.
  • All patients must have a review scan after the procedure between 1-2 weeks from the date of treatment.

What are the possible complications of Endoveous Laser Ablation?

Uncommon: Soreness or phlebitis which usually settles with Nurofen and tight compression stockings.

Very Rare: Deep Vein Thrombosis or Pulmonary Embolism is extremely rare but possible

Very Very Rare: Nerve damage which affects sensation in calf can extremely rarely occur.

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