Endovenous Laser Ablation ( EVLA / EVLT )

Venous insufficiency consequential to superficial reflux due to varicose veins is a serious problem that progresses inexorably if not treated timely. When the refluxing circuit encompasses failure of the primary valves at the saphenofemoral joint, however treatment options for such patients are limited and early recurrences are the rule than the exception.

Endovenous laser ablation (EVLA), also known as endovenous laser therapy (EVLT) is a minimally invasive procedure used for correcting venous reflux disease. It is also known as chronic venous insufficiency. Venous reflux disease is the underlying pathology that triggers varicose veins, and heavy, tired, achy legs. The procedure is done in the office under local anesthesia. Making use of ultrasound guidance, a laser fiber is inserted into the refluxing vein through a small nick in the skin. It is the laser energy that closes the vein permanently. The entire procedure lasts for forty-five to fifty minutes. You can drive after undergoing the procedure.

On the completion of the procedure, the blood is re-routed to healthy veins. Circulation of leg increases after this procedure. the surgeon wraps the led in an ace bandage for nearly forty-eight hours and a patient has to wear a compression stocking is worn for seven days. Walking is encouraged right after the procedure and the patient can resume normal activities either within the same day or the following day. A patient can resume full activities within seven to ten days. The doctor would prescribe the mild medication. Endovenous laser ablation surgery is highly effective in treating venous reflux with a long term success rate of 97 percent.

How is the surgery performed?

Image-guided, minimally invasive method such endovenous ablation is performed by an especially trained interventional radiologist. In most cases, the surgery is performed on an outpatient basis. However, some patients need admission following the procedure.

The surgeon might use a topical anesthetic cream over the abnormal vein area prior the surgery for reducing the discomfort. The leg which has to be treated would be cleaned, sterilized and then covered with a surgical drape. The doctor would numb the area where the catheter would enter into the abnormal vein with a local anesthesia and use the wand or ultrasound transducer for studying the vein and track its path.

A very small incision is made at the area to be operated.

Using ultrasound guidance, a catheter or vascular access sheath is inserted through the skin and positioned within the abnormal vein. The laser fiber or radiofrequency electrode is inserted through the catheter and the tip of the fiber or electrode is exposed by pulling the catheter back slightly.

Local anesthetic is injected around the abnormal vein with ultrasound guidance. Laser or radiofrequency energy is applied as the catheter is slowly withdrawn.

Pressure will be applied to prevent any bleeding and the opening in the skin is covered with a bandage. No sutures are needed. This procedure is usually completed within an hour.

Benefits of this procedure

  • It offers less invasive alternative to standard surgery.
  • No surgical incision is required – only a small nick in the skin is made which does not need stitches.
  • It is safe and complications free.
  • The procedure leaves no scars catheter placement needs skin opening of a few millimeter.
  • Most veins are treated effectively and are not visible even to ultrasound a year after the procedure.

What worries most people is the endovenous laser ablation cost. At Cosmecto, we strive to ensure that you get contacted with the surgeons who are experienced and have expertise in performing this procedure. Make sure you adhere to instructions given by the surgeon for timely recovery.

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