Endovenous Laser Ablation (EVLA): Modern Treatment Without Surgery

For decades, surgical stripping was the only option for large varicose veins — with general anesthesia, hospital stay, significant post-operative pain and weeks of recovery. Today, Endovenous Laser Ablation (EVLA) has completely changed the landscape: varicose veins are treated in under an hour, under local anesthesia only, and the patient walks out of the clinic on the same day.

What Is EVLA?

EVLA uses laser energy delivered through a thin fiber inserted directly into the diseased vein via a needle puncture — no incisions, no stitches. The heat produced damages the vein wall from the inside, causing it to close and gradually be absorbed by the body over the following weeks.

Who Is a Candidate?

• Patients with Great or Small Saphenous Vein incompetence
• CEAP classification C2 and above
• Leg pain, heaviness or swelling due to varicose veins
• Failed conservative treatment (compression stockings & medication) for at least 3 months
• Complications such as venous ulcers or thrombophlebitis

The Procedure Step by Step

1. Tumescent Anesthesia: Local anesthetic solution is injected around the vein to numb it and protect surrounding tissue from heat.
2. Laser Fiber Insertion: A thin laser fiber is threaded into the vein through a needle entry point, guided by real-time ultrasound.
3. Laser Energy Application: The fiber is slowly withdrawn while emitting laser energy, sealing the vein uniformly along its entire length.
4. Compression Dressing: A compression bandage is applied immediately to improve results and minimize bruising.
5. Walk & Go: The patient walks out of the clinic within 30 minutes of the procedure.

Advantages Over Traditional Surgery

• No general anesthesia, no operating theatre, no ventilation risks
• No surgical cuts, no sutures, no visible scars
• Significantly less post-procedure pain than stripping surgery
• Return to work and daily activities on the same or next day
• Higher long-term vein closure rates compared to surgery
• Total procedure time: 30–60 minutes

Post-Procedure Instructions

• Compression stockings: Wear for at least two weeks to optimize results and reduce swelling.
• Walking: Regular walking is encouraged from day one — it prevents clots and improves circulation.
• Avoid hot baths & swimming: For approximately one week.
• Mild bruising: Normal and resolves within two weeks.
• Duplex follow-up: One week post-procedure to confirm complete vein closure.