Endovenous laser ablation (EVLT or EVLA)

Endovenous laser ablation is a minimally invasive treatment for larger veins, particularly the greater saphenous and small saphenous veins. Me Clinic was one of the first clinics in Australia to perform this treatment.

It is used where a larger trunk vein is refluxing on ultrasound, or where varicose veins are extensive, bulging, or linked to a larger underlying reflux source. It is generally less invasive and less costly than vein surgery.

How it works

A fibre-optic probe is inserted into the affected vein. Laser light delivered through the probe heats the vein along its length, causing it to shrink through the effect of heat on the collagen in the vein wall. The treated vein then develops new collagen during healing, and blood is redirected through healthier veins.

The procedure is usually performed in clinic under local anaesthetic.

Advantages

Suitable for large veins that surface treatments cannot address.
Can be performed in both summer and winter, unlike some treatments where compression in hot weather is a barrier.
A shorter recovery period than vein surgery. Some patients are able to walk immediately after the procedure.
Minimal scarring given the size of vein treated.

Results vary between individuals, and your circumstances should be discussed with your doctor.

Combining with other treatments

After EVLT, any remaining surface varicose and spider veins can be treated with sclerotherapy. Treating the underlying refluxing trunk vein first, then addressing the surface veins, is a common sequence and generally gives a more durable result than treating surface veins alone.

What to expect afterwards

You are provided with an after-hours direct number in case you have questions or concerns.

Normal and expected

Bruising. Some bruising is expected, and some patients bruise more easily than others. Arnica ointment - supplied by the clinic or available from health food stores - can help.
Darkening. Some veins may turn dark soon after treatment and temporarily look worse before they look better.
Tenderness and redness along sections of the treated veins. This is not an infection. Walking rather than sitting reduces the soreness.
Lumps may form along sections of the treated veins. This is normal. Your doctor may treat them at a subsequent visit.

When to contact the clinic

Blisters over the skin. A dry dressing with a Melolin pad held with Micropore tape, changed daily, is usually all that is required.
Generalised rash or itching, particularly of the palms of the hands or soles of the feet. This most often indicates an allergic reaction - contact the clinic.
Discomfort that is not settling. Consult the clinic or your healthcare provider about pain management.

Activity after treatment

Walk up to 30 minutes daily while attending the clinic for treatment, and continue with your normal activities.
Avoid vigorous exercise such as aerobics or running in the first 24 hours, and while wearing compression-wrap bandages.
On a long car or plane trip, walk for at least five minutes every hour during the trip.

Compression stockings

After treatment your legs may need to be taped or bandaged. You should then wear your stockings whenever standing, as advised by your doctor. Stockings may be removed when lying in bed, or temporarily when showering - on during the day, off at night.

They may need to be worn for a number of weeks after treatment. Your doctor will advise how long applies in your case. Wearing them as directed materially affects the result.

Costs and Medicare

As at September 2024 and including GST, EVLT starts from $4,200, and a vein consultation with a doctor - which may include ultrasound - is $230. EVLT typically costs more than sclerotherapy but less than vein surgery. Where local anaesthesia is required, the cost is included in your quote.

You may be able to claim a Medicare rebate for vein treatment. Your physician will discuss any applicable rebates at your initial consultation, and you can contact Medicare directly for further detail. See varicose vein treatment costs.

Risks

All procedures carry some risk. EVLT is one of the vein treatments that requires anaesthetic. Risks are discussed with you in detail at consultation, and you are given written information to take home. Please read our information on the risks and complications of cosmetic surgery before proceeding.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.

Who performs EVLT

Dr Tim French (MED0001790529) is a phlebologist with AHPRA specialist and general registration and over a decade of clinical experience in venous medicine. He holds an MBBS, a Diploma of Surgical Anatomy (University of Melbourne), and further qualifications in phlebology and ultrasound in phlebology, and has worked at major hospitals including the Royal Melbourne Hospital and the Royal Adelaide Hospital.

See varicose veins, ultrasound-guided sclerotherapy, varicose vein surgery, or all vein treatments.