What is endovenous laser ablation (EVLA)?
The endovenous laser ablation procedure is performed by a physician trained in catheter manipulations and interventional radiology. The EVLA procedure is done in a special procedure room certified as an outpatient surgical center. The vein is numbed with local anesthesia, and the patient, though awake, is given sedatives for conscious sedation. A superb team consisting of an ultrasound technologist, an interventional radiology technician, a registered nurse and physcian perform the procedure.

A very thin bare laser fiber is inserted throught a catheter into a varicose veins through a tiny skin puncture. Laser energy heats up the vein causing it to shrink and collapse. The venous blood flow is then routed to healthy veins within the leg muscles. Any residual branch veins remaining after the EVLA procedure can be treated by the radiologist using ultrasound guided sclerotherapy during follow-up treatment sessions. Unlike surgical vein stripping where there is significant down time, patients treated with the EVLA procedure and/or with sclerotherapy have little or no down time, and can rapidly resume normal activities.

Treatments
With modern techonolgy, varicose vein treatment does not mean a hospital stay or long, uncomfortable recovery. Less invasive techniques generally allow varicose veins to be dealt with on an outpatient basis.

Conservative Treatment - Self-help measures such as exercising, losing weight, not wearing tight clothes, elevating your legs and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse. Varicose veins that develop during pregnancy generally improve without medical treatment within three months after delivery.

If you don't respond to self-help or if your condition is more severe, your doctor may advise one of following varicose veins treatments:

Catheter-assisted procedures - In this treatment, your doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is usually done for larger varicose veins.
 
Ambulatory phlebectomy (fluh-BEK-to-me) - Your doctor removes smaller varicose veins through a series of tiny skin punctures. Local anesthesia is used in this outpatient procedure. Scarring is generally minimal.