Manhattan Dermatology Specialists
  • MIDTOWN 56 W 45TH ST, STE 819 New York, NY 10036
  • UPPER EAST SIDE 983 PARK AVE, STE 1D1 New York, NY 10028
  • UNION SQUARE 55 W. 17TH ST STE 103 New York, NY 10011

Endovenous Laser Ablation

Endovenous laser ablation, also called EVLA or EVLT, is a procedure for treating varicose veins and their sequelae, such as venous stasis dermatitis and leg ulcers. The process employs lasers to heat and destroys the vein from within. This process of heating the vein until it collapses and scars over is called “thermoablation.” Endovenous laser ablation of varicose veins is used only for the large, long, straight veins that cause blue, ropy lines to appear on the surface of your skin. As science progresses and medical intervention becomes more specific and targeted, you benefit from less invasive techniques, decreased recovery time, and a reduction in aftercare issues. Your Manhattan dermatologist uses EVLA to target the underlying issues that cause your varicose veins, giving you a greater chance for a permanent solution.

Endovenous Radiofrequency Ablation

Endovenous radiofrequency ablation, also known as ClosureFasta, is similar to EVLA but utilizes radiofrequency rather than laser energy to target and collapse the treated vessel. Treatment and results are similar to EVLA. Often patients report less discomfort and bruising associated with endovenous radiofrequency ablation as compared to endovenous laser ablation.

Your Symptoms and Endovenous Ablation

The conditions and symptoms that EVLA or endovenous radiofrequency ablation can effectively treat include:

  • Thick, ropy, knotty varicose veins as seen just below the surface of your skin
  • Swelling of your feet, ankles, and legs
  • Tired, achy legs
  • Venous stasis dermatitis
  • Skin discoloration at your ankles
  • Venous leg ulcers

Like any procedure, especially targeted procedures, endovenous ablation of varicose veins isn’t recommended for all conditions. The procedure can’t treat:

  • Pelvic veins such as ovarian, testicular, internal iliac because of the vital organs that could be damaged by the laser
  • Vulval varicose veins that form after childbirth, usually due to pelvic congestion syndrome
  • Some recurrent veins after previous procedures, as they may be too small and need other treatments such as foam sclerotherapy.

Procedure for Endovenous Ablation of Varicose Veins

Your New York City dermatologist makes the procedure as comfortable and successful as possible. The procedure, while customized for your specific needs, generally follows a series of steps:

  1. You’re usually awake for this procedure as your doctor must be able to communicate with you about any pain or discomfort during the procedure to protect your nerves, muscle, and skin.
  2. Your skin is prepped, sterilized, and draped.
  3. Your Manhattan doctor uses ultrasound to identify the targeted vein.
  4. You’re positioned on the table head up to allow the vein to dilate and provide a larger target for the needles.
  5. Your skin is numbed with a local anesthetic.
  6. The entry point for the wire can be below the knee, at the ankle, in the thigh, or in the calf, depending on which vein is targeted.
  7. A hollow needle is inserted into the vein.
  8. Usually, the only entry site is the pinprick of the needle hole, but occasionally, if the vein is hard to reach or is moving, a small incision may be necessary.
  9. A wire is passed down the needle into the vein, followed by a sheath to guide and protect the optical fiber or laser device.
  10. A local anesthetic solution is injected around the vein, causing it to contract and also protecting surrounding tissues with the liquid.
  11. You’re then tipped head down on the table to help the vein contract.
  12. Direct laser energy is fired along the length of the wire inside the vein with the goal to point the laser towards the vein wall as the surgeon slowly removes the wire at a steady rate.
  13. The result is complete ablation or collapse of the vein that feeds the surface varicose veins. It should not reopen after treatment.
  14. As soon as the procedure is done, your doctor gets you up and moving around to reduce the chances of deep vein thrombosis.
★ ★ ★ ★ ★Susan Bard was very professional and very knowledgable right off the bat. I highly recommend she and her team.

The Pros and Cons of Endovenous Ablation

As with any medical procedure, there are advantages and concerns for endovenous laser ablation of varicose veins. The advantages include:

  • The process is minimally invasive, with usually only a few pinpricks.
  • It can lead to permanent ablation or collapse of the treated veins.
  • It produces significantly less bruising and post- operative pain than traditional methods, such as vein stripping.
  • Your post-operative mobility is back to normal immediately after the procedure.
  • Endovenous laser ablation recovery is much quicker than traditional invasive methods.
  • You can have endovenous ablation on an outpatient basis, often on the same day.

On the other hand, there are always the risks of endovenous ablation complications. Most risks are minor, making them easy to manage. Endovenous ablation complications can include:

  • You may require multiple pinpricks if the vein is large or your New York City doctor recommends it for successful ablation.
  • Endovenous laser ablation side effects include some discomfort, but over-the-counter medication, prescriptions, and cold compress helps.
  • There may be a change in your skin sensation at the injection site, but it usually resolves within a few weeks.
  • The procedure carries a risk of perforations of a vein wall resulting in increased bruising and pain.
  • There’s a small risk of regrowth of treated veins, but your doctor may try different frequencies and methods to reduce this risk.

Endovenous ablation of varicose veins produces better results with higher satisfaction rates as compared to traditional therapies. With this procedure, your Manhattan dermatologist corrects the discomfort and unsightliness of varicose veins without pain. With greater targeting abilities and less invasive techniques, your endovenous ablation recovery time and pain are decreased, allowing you to regain a healthy, active lifestyle.  

Important Reminder: This information is only intended to provide guidance, not definitive medical advice. Please consult dermatologist NYC about your specific condition. Only a trained, experienced board-certified dermatology doctor or pediatric dermatologist can determine an accurate diagnosis and proper treatment.

Updated on Mar 7, 2023 by Dr. Susan Bard (Dermatologist), Manhattan Dermatology Specialists Locations: Manhattan Dermatology (Upper East Side) 983 Park Ave, Ste 1D1, NY 10028
(212) 427-8750
Manhattan Dermatology (Midtown) 56 W 45th St, Ste 819, NY 10036
(212) 889-2402
Manhattan Dermatology (Union Square) 55 W 17th St, Ste 103, NY 10011
(212) 378-9984
DISCLAIMER: PLEASE READ CAREFULLY The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs you may be having. An accurate diagnosis and treatment plan should only be made by your physician in order to exclude a serious condition.
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