Say Goodbye to Varicose Veins: The Revolutionary EVA Treatment

What is Endovenous Ablation (EVA)?

EVA is an operation that is performed under local anaesthetic. The ‘leaky’ vein in the thigh or behind the knee that is causing the varicose veins is identified using an ultrasound scan.

A small local anaesthetic injection is given, and the treatment fibre is introduced into the leaky vein, which gently eases the vein.

More local anaesthetic is then administered around the site of the vein along the thigh or calf. The vein is then sealed off painlessly using either a laser or radiofrequency energy source.

The EVA operation normally takes between 40 and 60 minutes. A support bandage is applied to the leg from the foot up to the thigh. The support bandage needs to be kept on for 3-5 days.

How does EVA compare with conventional surgery, and what are its advantages?

EVA does not require the use of a general anesthetic; the procedure is performed entirely under local anesthesia. The 1-2 inch scar in the groin or behind the knee that results from surgery is avoided. In most patients, EVA is less painful than surgery, allowing an earlier return to work and normal activities. Results so far suggest that EVA is at least as good as surgery in treating varicose veins.

What are the Risks and Disadvantages of EVA?

In theory, the risks of EVA are deep vein thrombosis, skin burns, and nerve injury, but very few occurrences of any of these adverse effects have been reported up to now. Another difference between EVA and surgery is that EVA is a two (or three-stage treatment.

The first stage treats the cause of the varicose veins. Some patients may then need further treatment of any remaining varicose veins, which is done by injection (sclerotherapy) or surgical removal (phlebectomy).

However, in many patients, most of the varicose veins below the knee have improved so much after EVA that there is no need for a second procedure.

What happens after EVA?

You will have to wear a thigh-length support bandage for 3-5 days after you have had EVA, but you should be able to walk normally.

Depending on your occupation, you may need to take 2 – 7 days off work. We advise you not to drive for 1 – 2 weeks after EVA. You will be seen again in the clinic about 1 – 2 months after the EVLT to see if further treatment is needed for any remaining varicose veins.

Will the Varicose Veins come back?

If done correctly, EVA should give a cure rate of around 90%. The recurrence rate following EVA and conventional varicose vein surgery is commonly 5 – 10%. EVA and subsequent sclerotherapy or phlebectomy will have treated the original varicose veins.

However, you should be aware that new and separate varicose veins may still develop in the same leg in the future. These may need treatment. We would point out that EVA does not treat thread (spider) veins or venous flares (patches of tiny leaky vessels under the skin).