Endovenous Venous Laser Ablation (EVLA)
This is an office-based procedure that is also widely performed in major varicose vein centres all over the western world. It treats the incompetence of the truncal and the main branches of the truncal veins. It involves the introduction of a laser fibre within the incompetent vein under the guidance of a Doppler ultrasound. As the Laser is activated it is retracted at a predetermined rate, generating a tremendous level of energy. The new generation Laser fibres target the water component of the blood vessel wall and blood within its lumen. The intense energy generated produces what is called “steam bubble” causing irreversible damage to the vein wall being treated. Anaesthesia during the procedure is achieved by injecting an anaesthetic solution around the vein –again under ultrasound guidance – causing numbness of the vein and isolating it from the surrounding tissues.
It is considered as the treatment of choice for refluxing, technically suitable varicose veins by all the major phlebological colleges and societies in Australia, USA, UK, Europe and Canada. This is based on the evidence in published literature documenting its superiority over the surgical option in regards to success rate, safety, convenience and being an office-based procedure not requiring hospitalisation.