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Laser surgery (EVLA)
Endovenous Laser Ablation (EVLA) is a new method of treating the underlying conditions that cause varicose veins. Instead of using the old surgical approach, the EVLA method uses laser and it's heat to kill abnormal veins. It helps to restore healthy blood flow, fix associated vein symptoms and improve the overall appearance of the legs.
Varicose veins is a common problem. It develops when the the small valves inside the vein stop functioning properly, which means they let the blood fall the wrong way down the leg causing the damage.
The EVLA approach has been used since 2000 and proved to be safe and effective in treating varicose veins. It is performed under local anaesthetic and carried out as an outpatient procedure, meaning that patients can go home same day. Almost all patients with varicose veins are suitable for EVLA.
Who is it suitable for
✔ Patients with diagnosed varicose veins
✔ People suffering from pain, cramps, swelling legs
✔ Patients with visible lumps on their legs as a result of varicose veins
✔ Patients will need to do duplex ultrasound before proceeding with the EVLA procedure
Treatment duration
✔ EVLA procedure normally takes 30 minutes to couple of hours
✔ It is performed as an outpatient procedure, meaning that patients can go home same day
✔ The complexity and duration of this procedure vary from patient to patient, depending on their individual situation
Recovery
✔ Most patients experience little to no pain, and can resume daily activities in couple of hours after the EVLA procedure
✔ Some patients may experience pain and discomfort but it should normally resolve in about one week
✔ You should avoid heavy lifting exercises after this procedure
✔ Patients will need wear compression stockings for about one week
✔ It is common to have mild bruising for couple of weeks
Before The Treatment
Before the treatment, you will need to meet with a doctor to discuss your treatment plan and to perform an examination:
• Medical history - You should provide a complete medical history including your past and current health conditions, and medications that you might be taking. Your doctor is likely to ask you about any previous arterial and venous system problems, and related treatments.
• Examination, diagnostics - Your doctor will perform physical examination and a duplex ultrasound to diagnose the problem. Additional diagnostics might be required such as MRI or computerized tomography (CT).
• Goals and expectations - Be ready to discuss your treatment goals and expectations. Your doctor should explain you different types of procedures, potential risks, recovery and expected outcomes.
What does it involve?
Generally the following is involved:
• The EVLA procedure is generally performed under tumescent (local) anaesthetic and is guided by ultrasound scanning.
• You will be asked to inform a doctor immediately if you feel any heat or pain during your surgery.
• A doctor makes access to the inside of your veins by inserting a tiny needle with a laser fibre. Laser will be positioned close to saphenofemoral junction.
• Once access to the veins is made, a laser is fired up and it's heat is used to kill abnormal veins.
• During the surgery a doctor may need to make some incisions to remove tributarie veins.
• A bandage may be applied to reduce swelling and bruising.
EVLA procedure usually takes 30 minutes to 2 hours but can take longer.
After the treatment
The EVLA procedure is performed as an outpatient procedure, meaning that patients can go home same day. It is recommended that you avoid driving straight after the procedure and you should arrange for someone to drive you home or take public transport. Patient should be also aware that it is not advised to take long haul flights that are more than 4 hours for four weeks after this procedure.
Most patients experience little to no pain but some people may have discomfort and severe pain which normally resolves in one week post procedure. It is common to have mild bruising or swelling for couple of weeks. Most patients can resume daily activities just after couple of hours. However, patients experiencing pain or other symptoms may need to take one week off work for recovery. Patients should also avoid heavy lifting exercises for some time after this procedure.
You will need to wear support compression stockings for at least one week. You should also avoid swimming and getting your treated legs wet.
The EVLA treatment has shown to be successful for 98% of patients. It is rare that patients will have to come back for a second treatment.
Risks
The EVLA treatment is considered to be safe and serious complications are very rare. However, as with any medical procedure there are some risks:
• bruising and hematoma
• local parestesia
• thrombophlebitis
• nerver damage
• blod clots
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