What is the Difference Between EVLA and EVLT?

posted in: Varicose Veins

EVLA (Endovenous Laser Ablation) and EVLT (Endovenous Laser Therapy) are laser-based treatments for varicose veins. This piece explores the techniques, recovery time, and after treatment for varicose veins using Endovenous laser ablation (EVLA) and Endovenous Laser Therapy (EVLT).

What is the Difference Between EVLA and EVLT? - Vein Solutions

Differences between EVLA and EVLT?

EVLA is the abbreviation for Endovenous Laser Ablation. It relies on modern laser innovation to target and removes patients’ affected veins. It works by projecting laser heat energy on walls of the abnormal veins, which are then naturally discharged by the body as waste. It has many benefits compared to the traditional methods of vein stripping. EVLA is a minimally invasive procedure performed in a simple treatment room and does not involve any surgery to remove affected veins.

EVLT is an abbreviation for Endovenous Laser Therapy or Endovenous laser Treatment. EVLT is one of the first systems to rely on laser technology to treat patients with varicose vein conditions. However, unlike EVLA, EVLT is a patented trademark for a procedure from the Diomed company, which relies on the 810 mm laser diode.

EVLT pioneered in the year 2000, and over ten years later, multiple forms of varicose vein laser treatments have evolved from EVLT. Today, EVLA is the general term used to classify laser ablation treatments such as EVLT. EVLA is a collection of all treatments that rely on varying laser wavelengths ranging from 940 nm to 1320 nm. The method of treatment and recovery time is similar to that of EVLT.

How does EVLA work?

While some varicose veins are visible in the form of swollen and discoloured blood vessels, most people who suffer from this condition do not display any visible symptoms on the skin surface. Consequently, vascular specialists recommend patients undergo an ultrasound diagnosis to confirm the existence and severity of varicose vein conditions.

The ultrasound helps the specialist identify and mark suitable treatment positions in the problematic veins. The specialist then injects a local anaesthetic around the problematic vein to ease the nerves and minimize any discomfort during the treatment program. The doctor then has to get inside the affected vein by making a small incision and inserting a small needle through the incision area. The specialist then inserts a thin laser fibre through the needle, after which a thin plastic tubing (catheter) passes over the wire.

The vascular specialist then uses the lase to deliver short and continuous bursts of laser heat energy to the affected vein to ensure it no longer facilitates blood flow. The specialist then removes the laser fibre and seals the incision points using surgical tape.

The entire procedure can take anywhere between thirty minutes to a few hours, depending on the number of veins and limbs affected. Most patients can stand and walk immediately after the laser treatment.

Recovery time for EVLA and EVLT procedures

EVLA and EVLT are primarily walk-ins and walk-out procedures meaning patients can leave the treatment facility as soon as the treatment is over. Most patients can go about their daily routines a day after treatment.

Most doctors recommend wearing compression stockings to suppress any swelling or bruising after the procedure. These stockings will remain in use for two to three weeks. However, you will need to return to the clinic a few weeks after the treatment for a follow-up assessment. Another ultrasound scan will be necessary to assess the effectiveness of the treatment and any side effects.

Aftercare procedures for post-EVLA/EVLT treatment

Your vascular specialist will brief you on the best practices and what to avoid as you recuperate from the EVLA treatment. Below are some best practices for post EVLA patients

  • Ensure you take pain killers and anti-inflammation drugs as prescribed by the physician. Ibuprofen and paracetamol are common over-the-counter medications that are also used.
  • Ensure you wear the compressed stockings as directed by your physician.
  • While it is okay to return to work immediately after the treatment, you are better off taking a few days off if your job involves strenuous activity.
  • No alcohol and tobacco products for at least 48 hours after your treatment.
  • Avoid swimming or any activity that may wet your legs during the period when you have compression stockings.
  • Avoid sitting still for extended periods.
  • Light exercise by frequently walking after the treatment program. Light physical activity will boost blood flow in the affected leg, thus improving your recovery rate.

Risk and success rates

Varicose vein treatment using endovenous laser ablation poses minimal risk to patients due to its non-invasive nature compared to surgical procedures. However, some patients may experience bruising and mild discomfort that lasts a few days after treatment. Feelings of tightness, itchiness, and numbness in the affected leg are expected but will subside after a few weeks.

The elimination of spider veins will not affect blood flow in the affected area. The surrounding veins in the leg will take over the role of the subdued vein to ensure your leg receives sufficient blood flow.

Deep vein thrombosis or DVT refers to clotting of the veins in the legs, which is a risk that is inherent in all leg operations. The risk of developing DVT complications is significantly lower in EVLA than in traditional vein stripping methods. Skin burn is another potential risk, but it is extremely rare in EVLA related procedures.

Who qualifies for an EVLA procedure?

Laser vein ablation carries low risk and can be performed in patients with various underlying conditions. However, there are a few exceptions where EVLA is inadvisable.

  • If you are pregnant or still breastfeeding, EVLA might not be for you.
  • Patients with a history of deep vein thrombosis.
  • Patients with superficial veins too close to the skin surface do not qualify for EVLA.
  • Lastly, it could be challenging to insert laser fibre and catheters vital in EVLA treatment if your veins have severe deformation.

Patients who do not qualify for this treatment can typically be managed with foam sclerotherapy.


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