What is endovenous laser ablation (EVLA)? Endovenous laser ablation (EVLA)—also known as long-pulsed laser therapy—uses thermal energy to induce fibrosis within the vein, effectively sealing off the dilated vein. This method is highly recommended (Level I recommendation, Grade A evidence) by vascular societies worldwide for its safety and efficacy in treating bulging varicose veins from grade 2 and above. It offers excellent cosmetic outcomes and leaves no scars.
The procedure begins with the insertion of a sheath to guide the laser fiber to the targeted vein, under ultrasound guidance for precision. A cooling tumescent solution and local anesthesia are injected around the vein to protect surrounding tissues from thermal damage. The laser then delivers thermal energy to contract and seal the incompetent vein.
At Dr.Vein Clinic, the EVLA technique has been upgraded and developed into EVLA SafeClean, which improves upon the limitations of traditional EVLA. This enhanced method ensures complete removal of residual bulging varicose veins while minimizing side effects and post-treatment complications.
EVLA Laser – a method recommended by the International Union of Phlebology (UIP)
Endovenous laser ablation (EVLA), also known as long-pulsed laser therapy, is a technique in which a laser fiber is inserted into the vein and guided under ultrasound to the precise treatment site. Along the length of the vein, a tumescent solution is injected to provide local anesthesia and cooling, protecting surrounding tissues from thermal injury. The incompetent vein is thermally ablated, causing it to collapse and seal from within. The treated vein will be naturally absorbed by the body within a few months. This is a minimally invasive procedure that allows for quick recovery.
According to Dr. Phan Duy Kien, MSc (currently working at the Department of Vascular Surgery, Cho Ray Hospital): “For patients with bulging varicose veins (grade 2), endovenous long-pulsed laser (EVLA) is strongly recommended at the highest level by the International Union of Phlebology (UIP), with Level I recommendation and Grade A evidence according to evidence-based medicine.”
Steps of EVLA Treatment
- A sheath is inserted to guide the laser fiber into the vein. The surgeon monitors the position in real time using ultrasound imaging.
- A tumescent solution is then injected to cool and anesthetize the area around the vein. This solution helps protect surrounding tissues from heat.
- Thermal energy is activated to ablate the incompetent vein.
- The heat from the laser causes the vein to collapse and seal shut. The vein is then gradually absorbed by the body, eliminating the need for surgical removal.
02. Inject the tumescent solution
03. Activate thermal energy
04. Seal the vein lumen
Advantages of EVLA Laser in the Treatment of Venous Insufficiency
With a first-time treatment success rate of over 99% and a sustained success rate of over 95% after five years, EVLA is one of the most highly recommended methods worldwide for treating venous insufficiency, especially for hidden varicose veins.
This is a minimally invasive procedure. The vein is not surgically removed from the body, so no scarring is left, and recovery time is fast. Bruising and discomfort are minimal after the procedure.
The treatment is performed quickly, typically within one hour, without the need for hospitalization or general anesthesia.
Success rate 99,5%
Endovenous laser ablation (EVLA) has an initial vein closure rate of 99.5%. This rate is significantly higher compared to traditional vein stripping surgery, which has a recurrence rate of nearly 50% after five years.
Return to daily activities within 24 hours
EVLA is a minimally invasive procedure. You can return to work and normal activities the day after treatment. The entire procedure takes just one hour at Dr.Vein.
Immediate improvement
This method is highly recommended for its safety and definitive treatment results. Many patients report noticeable symptom relief immediately after the procedure.
Safe and effective
Minimally invasive approach reduces patient discomfort, enables faster recovery, and is suitable for multiple stages of venous insufficiency.
Post-EVLA Care Instructions
After EVLA treatment, patients will be instructed to wear compression stockings or follow a prescribed compression regimen. Two weeks after the procedure, patients will return for an ultrasound check to monitor the healing process. It is important to strictly follow the physician’s instructions to ensure optimal and timely recovery.
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