Patient Information – EVLA

Varicose Veins are a common clinical problem in North America. Varicose Veins affect approximately 20 to 25% of all adults and approximately 30 to 40% of all adult females. Risk factors for the development of Varicose Veins include family history, pregnancy, obesity, and occupations that require long periods of standing.

Endovenous Laser Ablation (EVLA) is a minimally-invasive technique for the treatment of large varicose veins. EVLA is performed in an office setting under local anesthesia. The technique involves placement of a fibreoptic device within the lumen of the vein to be treated and subsequent use of laser energy to seal the vein closed. Patients with many branches of the main venous route may require the use of injection sclerotherapy at the same time as the laser treatment or at subsequent follow-up visits. EVLA is performed under ultrasound guidance, which provides an accurate assessment of the location of the laser probe at all times. The advantages of this procedure include decreased patient bruising and discomfort, a rapid return to regular physical activities, and a better cosmetic result when compared to conventional high ligation and stripping of varicose veins.

Complications that may occur from this technique include allergic reactions to local anesthetic agents, temporary skin bruising along the path of the vein to be treated, temporary swelling and discomfort along the treated vein, temporary skin pigmentation along the path of the treated vein, and temporary numbness and tingling along the path of the treated vein. Skin pigmentation along the path of varicose branches or very superficial venous trunks is common and usually temporary. However, in some cases, prolonged pigmentation (many months) can occur. This is most commonly related to adjunctive injection sclerotherapy. Typically pigmentation will resolve spontaneously once healing has completely occurred (full cosmetic healing can take over a year). Rarely, sclerotherapy can result in permanent pigmentation along the treated vein.

An additional rare complication that has been reported with EVLA is Deep Vein Thrombosis (DVT). DVT is a potentially life threatening condition that occurs when the deep veins of the leg become blocked with clot. However, DVT is a readily treated condition that is easily and quickly diagnosed with ultrasound.  The incidence of DVT from laser vein surgery is less than one third of one percent (< 0.3%). This is less than the reported incidence with open (conventional) vein surgery.

The Davisville Vein Clinic (DVC) is a fully accredited Facility that has been inspected by the Out-of-Hospital Premises Inspection Plan (OHPIP). The OHPIP is managed by the College of Physicians and Surgeons of Ontario (CPSO) in order to ensure safe and appropriate treatment facilities for the citizens of Ontario. In addition, The DVC is affiliated with the Toronto Vascular Centre, which has achieved certification by the Intersocietal Commission for the Accreditation of Vascular Laboratories (IAC).

Dr. Kucey is a fully trained Vascular Surgeon with both Canadian and American Certification. He has over 20 years of clinical experience in Vascular Surgery. He is affiliated with the University of Toronto and Sunnybrook Health Sciences Centre. He was instrumental in the development of this technique in Canada and has performed over 1200 ELVA procedures.