What is EVLA (Endovenous Laser Ablation) for varicose veins?

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From the Guidelines

EVLA stands for Endovenous Laser Ablation, a minimally invasive procedure used to treat varicose veins, which has been shown to have high success rates and low recurrence rates compared to traditional vein stripping 1.

Overview of EVLA

EVLA is a technique that uses laser energy to heat and close problematic veins, particularly the great saphenous vein. During the procedure, a thin laser fiber is inserted into the affected vein under ultrasound guidance, and laser energy is delivered to seal the vein shut.

Key Benefits and Considerations

The procedure typically takes 30-60 minutes, requires only local anesthesia, and patients can usually return to normal activities within 24 hours 1. After treatment, blood naturally reroutes through healthier veins, improving circulation. EVLA offers several advantages over traditional vein stripping, including:

  • Less pain
  • Minimal scarring
  • Faster recovery time
  • High success rates with low recurrence Patients may experience mild bruising, tenderness, or tightness for a few days post-procedure, but these symptoms typically resolve quickly. Compression stockings are often recommended for 1-2 weeks following treatment to aid healing and improve outcomes.

Comparison to Other Treatments

Multiple recent meta-analyses confirm that EVLA and radiofrequency ablation (RFA) are at least as efficacious, if not slightly more so, than surgery 1. When compared to surgery, EVLA had fewer rates of bleeding, hematoma, and wound infection. EVLA and RFA were also noted to have reduced rates of paresthesia compared to surgery.

Current Recommendations

Current data on RFA versus EVLA is rather limited, although there have been some recent developments. However, EVLA is recommended as a first-line treatment for nonpregnant patients with symptomatic varicose veins and documented valvular reflux, and need not be delayed for a trial of external compression 1.

From the Research

EVLA Acronym Vein

  • EVLA stands for Endovenous Laser Ablation, a minimally invasive treatment for varicose veins 2, 3, 4, 5, 6
  • The procedure involves the use of a laser to close off the affected vein, and is often performed under local anesthesia 2, 5, 6
  • EVLA has been shown to be a safe and effective treatment for varicose veins, with high success rates and low complication rates 2, 3, 4, 5, 6

Key Findings

  • A study published in 2015 found that EVLA with miniphlebectomy was effective in treating varicose veins, with an overall occlusion rate of 95% 2
  • A 2020 study compared EVLA with and without concomitant phlebectomy, and found that there was no significant difference in the rate of additional sclerotherapy between the two groups 3
  • Another 2020 study reviewed the literature on EVLA and found that it is a safe and durable treatment option for the management of incompetent superficial and perforator veins of the lower extremities 4

Procedure Details

  • EVLA is typically performed under local anesthesia, and can be done in an office setting with immediate return to full activity 5, 6
  • The procedure involves the insertion of a laser fiber into the affected vein, which is then heated to close off the vein 2, 5, 6
  • Post-procedural care typically includes follow-up appointments to monitor the treated vein and check for any complications 2, 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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