Sealing Shut the Problem Veins: Endovenous Laser Ablation (EVLA)
The Great or Small Saphenous Vein (GSV or SSV), located in the inner thigh and leg, or at the back of the calf, respectively, are sealed shut by laser energy, resulting in closure of the vein so it cannot carry blood and cause reflux. What happens to the blood that these veins carried? Your body sends the blood to normal veins. This procedure, in fact, actually normalizes the venous circulation in the leg!
On the day of your treatment, your leg will be rescanned and the veins measured. Your leg will then be cleaned with an antibacterial solution. After the area is numbed with lidocaine (a local numbing medication), a tiny intravenous (IV) catheter will be inserted into the vein, usually at the level of the knee. Via the IV a laser fiber will be fed through the vein to the upper thigh. This part is painless as the vein does not have any nerve fibers inside of it. After that, the vein around the laser fiber is numbed with more dilute medication. The laser is then fired to seal shut the vein which you didn’t need in the first place. Your body will then immediately redirect the blood to healthy veins. (Your body has 50,000 miles of veins and doesn’t need this one.) The vein will then convert to scar tissue and your body will absorb it. In fact, when you return for follow-up visits we won’t even see it with the ultrasound.
After the laser is withdrawn, we will cover the insertion site with a Band-Aid and apply a compression hose over the leg. You will wear the hose around the clock for the first 24 hours, and then during the day for the following week, removing it only to shower and to sleep. We will see you back in the office in one week. Postoperatively you should expect to have some mild soreness and a pulling sensation in the thigh where the vein is shrinking. Most people take a Tylenol for a day or so but don’t need anything stronger than that for any soreness.
The majority of patients only need an Ablation to normalize the vein circulation and make their legs feel good again and prevent most of the problems associated with vein problems.