Endovenous laser ablation (EVLA): Laser Treatment For Varicose Veins

1. Consultation

Your journey with EVLA begins with a free initial consultation. We can offer a discussion over the phone but you will need to come into one of clinics for one of our experts to assess your condition in more detail, discuss your symptoms, medical history, and perform a thorough examination of your veins via duplex ultrasound. This evaluation is crucial in determining if EVLA is the most appropriate treatment for your varicose veins.

2. Preparations

Ahead of your procedure our team will guide you through the necessary preparations and will be available as required to discuss any further questions you may have post your initial consultation.

You will receive detailed guidelines regarding any necessary preparations before your treatment. These may include:

• Fasting: You may be instructed to avoid eating or drinking for a specific period of time before the procedure.
• Medication: During the consultation, we will gather details about your current medications or supplements. Some medications, like blood thinners, may require adjustments before the procedure.
• Clothing: On the day of your treatment, choose to wear loose, comfortable clothing to ensure ease of movement.

Adhering closely to our pre-treatment instructions is crucial for optimising the procedure and mitigating potential risks.

3. Local anaesthetic

Prior to the start of the procedure, a local anaesthetic will be injected to numb the area. This guarantees your comfort and ensures a pain-free experience throughout the treatment. Following the anaesthetic, you shouldn’t feel any kind of significant pain during EVLA, however, you may feel some slight discomfort or a strange sensation whilst the laser is active. If this becomes too much, please let your surgeon know as soon as possible.

4. Catheter insertion

Once the area is properly anaesthetised, a small catheter will be inserted into the affected vein under ultrasound guidance. A laser fibre is then passed through the vein into the correct position.

5. Laser energy delivery

With the fibre in place, laser energy is emitted into the targeted vein. The laser energy is absorbed by the vein walls, heating them up until they collapse and seal shut. Blood flow is then redirected to the healthy surrounding veins, improving circulation and alleviating symptoms. After treatment, your varicose veins will eventually fade away completely, returning your skin to its healthy appearance.

6. Compression and recovery

Once the procedure is complete, our staff will apply bandages to the treated area and compression stockings may need to be worn. This will support the healing process and help to maintain proper blood flow following treatment.

You will have the opportunity to relax in our recovery room, however, as this is an out-patient procedure you will be able to return home on the same day as your treatment. We will ask you to take a short walk before leaving us to ensure that there are no complications with circulation.

Your surgeon will advise on ways you can help to aid recovery, which will likely include the following:

• Wear compression stockings for a few weeks after the procedure to aid circulation and prevent blood clots.
• Stay hydrated by drinking plenty of water to avoid constipation, which can put pressure on your veins and prevent proper healing.
• Take it easy and avoid any strenuous activities, including heavy lifting and exercise, for at least a week. This will give your body the time it needs to heal.
• Keep the area clean to avoid any infections. Avoid taking baths or soaking in a hot tub for a few days after the procedure.
• Follow up with your surgeon to monitor your progress and ensure that you are healing correctly. A follow up session with your surgeon is included within your treatment price.

• Minimally invasive: EVLA is a minimally invasive procedure, which means it requires only a small incision or entry point. This leads to less scarring, reduced pain, and a quicker recovery time compared to open surgery.
• Highly effective: EVLA effectively treats the underlying cause of varicose veins by closing off the malfunctioning vein, improving blood flow, reducing symptoms, and returning the affected area to its healthy appearance. After 6 months, the success rate for EVLA has been reported to be around 95%.
• Local anaesthetic: EVLA is typically performed under local anaesthetic, eliminating the risks associated with general anaesthetic and allowing for a shorter recovery time.
• Outpatient procedure: Our EVLA treatments are performed on an outpatient basis, meaning you can return home on the same day without taking significant time out from your busy schedule.
• Rapid recovery: Patients who undergo EVLA usually experience a faster recovery compared to traditional vein surgery. Many can resume their normal activities within a day or two.
• Minimal scarring: EVLA requires only a tiny incision, resulting in minimal scarring. The incision is often so small that it may not require sutures, further improving cosmetic outcomes.
• Low risk of complications: The risk of complications with EVLA is generally lower compared to traditional surgical treatments, including reduced risk of infection, nerve damage, or wound healing issues.
• Long-lasting results: EVLA provides long-lasting relief from varicose veins. The treated vein does not typically return, reducing the need for you to return for further treatments.

• Thrombophlebitis: Superficial thrombophlebitis, a condition where blood clots form in the treated vein, is a potential complication. These clots are usually small and near the surface of the skin, causing pain and inflammation. Clots like this are not dangerous and they should disappear naturally. Further medical attention may be required to manage this if it occurs.
• Nerve damage: In extremely rare cases EVLA can irritate nearby nerves, leading to prolonged discomfort or altered sensation in the treated area. This will usually heal within a few months.
• Skin burns: In rare cases, skin burns can occur if the laser energy affects the skin surrounding the vein. All of our procedures are carried out by experienced vascular surgeons, who take precautions to minimise this risk.
• Deep vein thrombosis (DVT): Although extremely rare, there is a minimal risk of a DVT occurring as a result of EVLA. DVT is a condition where blood clots form in deeper veins, potentially leading to more significant health issues.
• Infection: Although rare, there is a minimal risk of infection at the site of the procedure. Signs of infection include increased pain, redness, swelling, or discharge from the incision site and can be treated by your healthcare team if required.
• Scarring: Whilst EVLA typically results in minimal scarring, there is a possibility of scarring at the incision site, particularly if it is not cared for properly during the healing process.
• Bruising and swelling: Bruising and swelling around the treated area are common side effects of EVLA. These usually subside within a few weeks but can be bothersome during the initial recovery period.
• Allergic reaction: Some patients may have an allergic reaction to the materials used during the procedure, such as the local anaesthetic or adhesive. Your healthcare team will record any known allergens ahead of your procedure and monitor you for any adverse reactions during treatment.
• Recurrence: Whilst EVLA is highly effective, it is possible for new varicose veins to develop over time (typically 1 in 5 people will suffer recurrence after 5 years). These new veins would require additional treatment if they become problematic.3
• Skin discoloration: Skin discoloration along the treated vein can occur, which may persist for several months or, in some minor cases, be permanent.