What is the actual procedure like?

The EVLA procedure takes about 45 minutes and is performed in a treatment room with you lying on a treatment table.. No general anaesthesia is required, just a local anaesthetic. Your surgeon will insert a thin flexible fibre into the faulty vein.

The laser emits thermal energy that will close the vein from the inside. Only minimal discomfort, if any, should be experienced due to the local anaesthetic that is administered along the length of your vein.

The procedure begins with an ultrasound scan to mark the vein in your leg to be treated.
  • An injection of local anaesthetic is given to freeze the skin over the vein.
  • A small needle is inserted into a vein at this point and a flexible wire is passed up the vein. You will not feel this.
  • A fine tube is passed over the wire into the vein and the laser filament is threaded up this.
  • The position of the laser fibre is checked with an ultrasound scan.
  • Once the laser fibre is in the right place some more local anaesthetic is injected around the vein to minimise any discomfort when the laser is turned on.
  • The laser works by closing up the vein from the inside.
  • Lasers are powerful sources of energy and you and the staff will wear protective eyewear whilst the laser is being used.
  • When the vein has been sealed up, the laser is removed and a bandage or compression stocking is applied to the leg. You should keep this on for 7 days following which a support stocking, which we will give you, is worn for another week.
What happens after the treatment?
  • After EVLA you will be asked to walk around for 15 minutes, have a drink, and then go home. You should not drive and if travelling by car for more than 1 hour sit on the rear seat with your leg(s) on the seat. You should stop hourly and walk for 5 minutes.
  • During the first few days you may feel some discomfort or tightness over the treated vein. Although it is not necessary to take pain-killers routinely if you feel that these are required then either paracetamol or an anti-inflammatory drug such as nurofen or brufen (available from chemists "overthe counter") should be sufficient. You should not take anti-inflammatory drugs if you have had a stomach ulcer or haemorrhage or if you suffer from asthma.
  • If any discomfort persists, or becomes more severe after the first 3-4 days then it is a good idea to see your GP.  They may prescribe a stronger anti-inflammatory drug such as diclofenac (it is suggested that you print out this information and take it with you if you visit your GP).  About 15% of patients experience pain that requires treatment for up to a week after treatment.
  • Normal activity, including work, can be resumed as soon as you like although we suggest avoiding contact sports, the gym and swimming for 2-3 weeks after EVLA. Around 65% of patients return to work the following day. The remainder do so over the next 2-5 days. This is much quicker than after varicose vein surgery.
  • When the bandage is removed after 7 days some minor bruising over the treated vein is normal together with some hardness under the skin. This will settle down.
  • We will arrange to see you about 6 weeks after the procedure. By then most of your varicose veins will have shrunk and many may have disappeared. If some remain these can be treated by injection treatment. This is a routine outpatient treatment which we currently use for less severe varicose veins. The injection treatment replaces the small wounds that are made in the leg to remove the lumpy veins during surgery.