What is EVLA? 

EVLA is a new method of treating varicose veins without surgery. Instead of tying and removing the abnormal veins,they are heated by a laser. The heat kills the walls of the veins and the body then naturally absorbs the dead tissue and the abnormal veins are destroyed. It can be carried out in a simple treatment room rather than an operating theatre.



How does it work?

EVLA is performed under local anaesthetic, there is no need for a General Anaesthetic- in fact using General Anaesthetic to perform Endovenous  Laser Ablation:

  •  adds the risk of an unnecessary general anaesthetic
  •  adds extra cost (for the anaesthetist and general anaesthetic theatre equipment and theatre)

To perform EVLA, the surgeon needs a map of the veins to show which ones are the problem. This map is made using Duplex Ultrasound.

At the EVLA procedure, the surgeon uses ultrasound to find the vein to be treated. The veins that can be treated are the main venous trunks of the legs:

  • Great Saphenous Vein (GSV)
  • Small Saphenous Vein (SSV)

Their major tributaries such as the Anterior Accessory Saphenous Veins.




Under ultrasound control, a needle is put into the vein near the knee or ankle. A wire is passed into the vein and a long ‘sheath’ is passed up the vein to the top. This ‘sheath’ is a thin tube about the width of a biro refill.

The ultrasound is used to position the end of the sheath exactly.

Local anaesthetic is injected around the vein – again using ultrasound to make absolutely sure the fluid is in the right place. The local anaesthetic fluid has 3 uses:

  • Local anaesthetic numbs the vein and the surrounding tissue
  • Adrenaline in the mixture causes the vein to contract onto the laser sheath giving good contact
  • The volume of fluid disperses the laser energy – making sure the tissues around the vein are not harmed when the vein is destroyed by heat.

What happens after treatment?
Soon after your treatment you will be allowed home. It is advisable not to drive but to take public transport, walk or have a friend drive you. You will have to wear the stockings for up to two ​weeks and you will be given instructions about how to bathe. You should be able to go back to work straight away and get on with most normal activities.
You cannot swim or get your legs wet during the period in which you have been advised to wear the stockings. Most patients experience a tightening sensation along the length of the treated vein and some get pain in that area around 5 days later but this is usually mild. Normal anti-inflammatory drugs like Ibuprofen are normally sufficient to relieve it.
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