Endovenous Laser Ablation (EVLA) uses a laser fibre, which is inserted into the abnormal vein via a small skin puncture.

The fibre is then fed into the vein under ultrasound guidance. Around the length of the vein, we inject a tumescent solution, providing local analgesia, and protecting the tissues around the vein from any heat damage. The solution also helps collapse the vein we are treating.

Then, we activate the laser and the fibre is slowly removed. The laser’s heat destroys the cells lining the vein wall, and the actual vein is then gradually resorbed by the body over a period of months.  

Our primary vein closure rates after a single laser treatment are >99.5%, closure rates of large veins after foam sclerotherapy have been reported anywhere from 25-85%. A lot depends on the size of the vein, wall thickness and techniques used. Vein reopening after sclerotherapy is much more common than after laser.

EVLA is very well tolerated, and has superior success rates (and lower recurrence rates) compared to traditional vein removal methods such as surgical vein stripping. The discomfort after your procedure is usually less significant than after surgical vein stripping and hence recovery time shorter than with older vein removal techniques.

EVLA was popularised in the late 1990s by American Radiologist Dr Robert Min. In 2002, Endovenous Laser Ablation was introduced in Australia, and since then the side effects have been reduced thanks to further advances. For example, higher frequency laser energy is now used (1470 nm), as well as a more specialised laser fibre design.

The illustrations below show the “before/after” story of a 50yr old man suffering from varicose veins. The incompetent Great Saphenous Vein or GSV was feeding these veins, and we eliminated it through a single IV puncture site, using 1470 nm laser and a “radial” fibre for less discomfort. Two weeks later the “branch vessels” have reduced in size, and ultrasound guided sclerotherapy was administered at 3 months to close the small remaining branches. The last picture shows the 18 month follow-up, with all prominent veins resolved. Without the need for vein surgery!