Endovenous Laser/Radiofrequency Ablation (EVLA / EVRF)

Endovenous Thermal Ablation is an image-guided, less invasive treatment. In this, It uses radiofrequency or laser energy for cauterizing (burn) and closing the abnormal veins that lead to varicose veins. Ablation is safe, minimal invasive than surgery, and with no virtual looking scars.


Everything about EVLA / EVRF

How does EVLA / EVRF work?

An electrode or fiber is moved to the desired location within the vein via a small incision. Tumescent anesthesia is injected into the tissues around the vein to collapse the vein around the fiber or electrode and act as insulation for the energy’s heat. This energy heats the veins vessel and causes it to close.

Why is EVLA / EVRF the best treatment for Varicose Veins?

The success rates of 5 Years of EVLA / EVRF which have been reported worldwide are in the range of 95 – 98 %. Compared to other treatment modalities like Foam Sclerotherapy (80-95%) & Open Ligation & Stripping Surgery, this is better. The only problem is the high cost of EVLA / EVRF.

Are you the right candidate for EVLA / EVRF ?

During your consultation, the doctor will assess your varicose veins in detail. The causative factors and severity of your veins will be analysed along with your duplex ultrasound report. After this clinical examination, your eligibility for the procedure and whether you really need it can then be explained to you.

EVLA / EVRF Procedure Explained

How does the procedure work?
Via a small incisions, an electrode or fiber is moved to the desired location within the vein. Local anesthesia is given into these tissues around the vein. This helps to collapse the vein around the fiber or electrode. And it acts as insulation for the energy’s heat. The energy causes vessel to close with the heat. After the procedure, the faulty vein will shrink.

What does the equipment look like?
This procedure uses an ultrasound machine, radiofrequency / laser fiber, and console.
Ultrasound machines are a device which uses sound waves to detect the location and condition of veins in the body.
A catheter is a long, thin plastic tube that is considerably smaller than a “”pencil lead””, or approximately 2 mm in diameter.
Laser fibers and radiofrequency electrodes are long thin wires that carry energy from power generators into the body.

How is the procedure performed?
This procedure is often done on a daycare basis. However, some patients may require admission after the procedure. The area where the catheter enters the abnormal vein will be numbed with a local anesthetic. Using guidance of ultrasound a catheter is inserted through the skin and positioned within the abnormal vein. Through the catheter the fiber or electrode is inserted. By pulling the catheter back slightly the fiber or electrode tip is exposed. Local anesthesia is injected around the abnormal vein with ultrasound guidance. Energy heats the vein when the catheter is slowly withdrawn. Pressure is applied to prevent any bleeding and the skin is covered with a bandage. No sutures are necessary. This procedure is usually completed within an hour.What will I experience during the procedure?
You will feel slight pinpricks as the local anesthetic is injected at the vein access site and along the length of the vein. Within a short time this area becomes numb. Injection of local anesthetic around the vein is the most uncomfortable part of the procedure because it usually requires multiple injections along the vein. With heat actual closure of the vein is not painful. Doctor prescribes to wear a gradient compression stocking after treatment. You can resume normal activity immediately, avoiding prolonged sitting. Do not spend too much time in bed, stay active during recovery time. However, sometimes after procedure, you should avoid strenuous physical activity.

Who interprets the results and how do I get them?
Ultrasound exams are necessary to assess the treated vein and even to check for adverse outcomes during follow up. Generally, within one week, the target vein gets successfully closed. Additional procedures such as phlebectomy or sclerotherapy may be necessary for treating associated veins.

What are the limitations of Endovenous Ablation of Varicose Veins?
Ablation helps for closing the abnormal target vein almost 100 percent of the time. Ablation catheters are difficult to pass through a vessel with many turns and bends. Also small, dilated branches that persist in the skin often require additional treatment. These treatments may include phlebectomy or sclerotherapy. Your doctor generally schedule subsequent treatments after an ablation procedure. But phlebectomy can also be performed at the same time as endovenous ablation.

Frequently Asked Questions

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