Endovenous Laser Ablation
EVLA — Laser Treatment for Varicose Veins Without Surgery
EVLA is the method international clinical guidelines call the gold standard for treating varicose vein disease: a laser fiber inserted through a tiny skin puncture closes the diseased vein from within, immediately rerouting blood through healthy veins. No incisions, no stitches, no general anesthesia — the procedure is performed under local anesthesia with continuous ultrasound guidance, and you go home the same day.
40–60
minutes for the entire procedure
0
incisions or stitches — just a needle puncture
>95%
of veins remain closed in international studies
1 day
and you're home, walking right away
Who Is This Procedure For
- Varicose great or small saphenous vein with reflux (reverse blood flow) confirmed by vein duplex ultrasound
- Varicose tributaries and nodules due to insufficiency of the main truncal vein
- Swelling, heaviness, and night cramps — symptoms of chronic venous insufficiency
- Early trophic skin changes on the lower leg: darkening, hardening
- Recurrent varicose veins after previous surgery — based on vein duplex ultrasound findings
Contraindications
- Acute deep vein thrombosis
- Pregnancy and breastfeeding — treatment is postponed
- Severe arterial ischemia of the legs (advanced atherosclerosis)
- Acute infections or skin inflammation in the procedure area
- Inability to wear compression stockings and walk actively after the procedure
The precise list of indications and contraindications is determined during your consultation based on vein ultrasound results.
How the Procedure Works
- 1
Ultrasound Mapping
Immediately before the procedure, I map the diseased vein and its tributaries under duplex scanning — both standing and lying down.
- 2
Local Anesthesia
Tumescent anesthesia is applied around the vein: it numbs the area, protects surrounding tissue from heat, and compresses the vein against the laser fiber.
- 3
Puncture & Fiber Placement
Through a single needle puncture — no incision — a thin laser fiber is introduced into the vein and positioned precisely under ultrasound guidance.
- 4
Laser Coagulation
The Biolitec Leonardo laser with a radial fiber uniformly seals the vein walls along their entire length — I monitor every centimeter by ultrasound.
- 5
Compression & Walk
We apply compression stockings, and after a 30–40 minute walk you leave the clinic on your own.
Benefits of the Method
German Biolitec Leonardo Laser
Radial fibers and precisely dosed energy deliver uniform vein closure with minimal trauma to surrounding tissue.
No Incisions, No General Anesthesia
A single needle puncture and local anesthesia: no scars, no hospital ward, no recovery from general anesthesia.
Ultrasound Guidance at Every Step
From mapping to final check — the entire procedure runs under continuous duplex scanning.
On Your Feet Immediately
Walking starts right after the procedure; desk work is typically possible the very next day.
One Doctor, Full Cycle
I personally handle diagnosis, the procedure, and all follow-up appointments — including complex and recurrent cases.
Recovery: What You Need to Know
- Compression stockings: around the clock for the first few days, then during the day only — I'll tailor the exact schedule to you
- Daily walking for 40–60 minutes — the best way to prevent complications
- Scheduled follow-up vein duplex ultrasound: typically at 2–3 days and again at 1–2 months
- Avoid saunas, steam baths, hot baths, and heavy strength training for 2–4 weeks
- A mild pulling sensation along the treated vein during the first week is a normal reaction
EVLA or sclerotherapy?
These methods solve different problems. The laser closes the diseased trunk — the source of reflux; sclerotherapy clears tributaries, reticular veins and spider veins. They often complement each other in a single visit. Duplex ultrasound shows what you actually need — and at the consultation I'll explain it with no bias toward a favourite method.
Pricing
The cost depends on the diameter and length of the vein, the volume of anesthesia required, and whether simultaneous miniphlebectomy or sclerotherapy of tributaries is needed.
Endovenous Laser Ablation (EVLA)
per estimate after ultrasound- The initial consultation includes a vein ultrasound and a personalised treatment plan
- Your cost estimate is confirmed in writing before the procedure and will not change
Frequently Asked Questions
Is EVLA painful?
The only noticeable discomfort is the anesthetic injections — similar to a dental procedure. During coagulation patients feel warmth or mild pressure, but no pain. By evening, one over-the-counter painkiller is usually enough — and not everyone needs even that.
What happens to the closed vein?
The treated vein gradually reabsorbs: over several months the body replaces it with connective tissue. From day one, blood flows through healthy deep veins — the diseased vein was not participating in normal circulation anyway.
When can I drive and return to work?
You can drive the same day. Desk work is fine the next day. If your job involves heavy physical labor or prolonged standing, we'll discuss the timeline individually — typically 1–2 weeks of light activity.
Can both legs be treated at once?
It is technically possible, but the decision is based on ultrasound findings and the scope of the procedure. In many cases it is more comfortable to treat each leg with a 1–2 week interval.
Will varicose veins come back after EVLA?
A correctly closed vein does not reopen — studies show more than 95% of treated veins remain permanently closed. However, varicose vein disease is chronic: over the years other veins may enlarge. An annual ultrasound check allows new veins to be treated with sclerotherapy at an early stage.
How is EVLA different from conventional surgery?
Phlebectomy involves incisions, general or spinal anesthesia, hospitalization, and weeks of recovery. EVLA achieves the same goal through a needle puncture under local anesthesia: no scars, outpatient setting, back to normal life the next day.
Related reading
CLaCS
A transdermal laser plus a sclerosant in the feeding vein, with skin cooling — for stubborn spider veins.
Sclerotherapy
Sclerosant injections eliminate spider veins and small vessels — no incisions, no scarring.
Miniphlebectomy
Removal of varicose nodes through 1–2 mm micro-incisions — no stitches, no visible marks.
Vein Duplex Ultrasound
Duplex ultrasound of both legs with a full report and treatment plan — all at your very first appointment.
This material is for information purposes and does not replace a doctor’s consultation. An exact diagnosis and treatment plan are established at an in-person consultation with a vein ultrasound.
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