Advanced Vascular Centre, Mount Elizabeth
#13-06 Mount Elizabeth Medical Centre
+65 6737 1180
Endovenous laser treatment and what to expect
Recovery from endovenous laser treatment usually takes a few days to around a week
After the procedure, Dr Desmond Ooi usually sees you twice, and a further ultrasound scan may be arranged to check the treated vein.
By Dr Desmond Ooi
Senior Consultant, Advanced Vascular Centre
More than 15 years of experience in vascular and general surgery
How long endovenous laser treatment lasts depends on more than the procedure itself
Over the following months, the body absorbs the vein the laser has closed. Varicose veins can still return, most often because a different vein develops leaking valves. The scan beforehand looks for every significant leaking vein, and you are reviewed afterwards.
Questions about how long it lasts
How endovenous laser treatment closes the affected vein from the inside
Endovenous thermal ablation is a minimally invasive procedure used to treat varicose veins. It involves the application of heat energy, either through laser or radiofrequency, to seal off the affected veins.
Endovenous laser treatment is the form that uses laser energy. It is also known as endovenous laser ablation (EVLA) and endovenous laser therapy for varicose veins, or EVLT for short. The vein is sealed inside the leg rather than removed.
During the procedure, a thin catheter is inserted into the affected vein using an ultrasound device.
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Local anaesthetic is administered.
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The affected vein is identified through ultrasound.
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A catheter is inserted through a small needle puncture and guided to the affected vein.
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A specialised tool is guided through the catheter to generate laser or radiofrequency waves. For endovenous laser treatment, this tool is a fine laser fibre.
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A numbing fluid is injected around the vein.
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Laser energy is delivered as the fibre is slowly drawn back along the vein. The affected vein is sealed off.
This causes the vein to collapse and eventually be reabsorbed by the body.
Who endovenous laser treatment suits, checked with an ultrasound scan beforehand
Varicose veins occur when the valves within the veins become weak or damaged, leading to improper blood flow and pooling. This can result in discomfort, pain, swelling, and cosmetic concerns.
Before undergoing endovenous thermal ablation, a pre-procedure evaluation is typically conducted to ensure the patient's suitability for the treatment. This evaluation often involves an assessment of the venous system using ultrasound imaging. The ultrasound helps to identify the location and extent of the affected veins, allowing Dr Desmond Ooi to plan the procedure accordingly.
Whether laser suits you depends on the size, course and shape of the affected vein, any earlier vein treatment, how well the deep veins work, and your general health.
Varicose veins, their causes and symptoms
What to expect on the day of the procedure
Patients may be advised to discontinue certain medications before the procedure.
The treatment is usually carried out in an outpatient procedure room or a day surgery centre. It typically takes 30 to 60 minutes, depending on how many veins are treated.
- You may feel a brief sting as the local anaesthetic goes in, and mild pressure while the catheter is positioned
- During the laser treatment itself, most patients feel little or no pain
- A walk of 20 to 30 minutes is usually encouraged before going home
- It is a day procedure, and patients usually go home on the same day
Recovery after laser treatment, from walking to compression stockings
After undergoing endovenous thermal ablation, there are several important post-procedure instructions to follow. These include:
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Elevating the leg when sitting down to promote blood circulation
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Wearing compression socks to aid in healing
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Remaining active with regular walking to promote blood flow
By adhering to these instructions, patients can optimise their healing.
Patients can generally expect to return to work within a week or so, depending on their individual healing progress. While exercise is encouraged, it is recommended to start with simple activities such as walking and gradually increase intensity, taking it easy during the first week.
Some individuals may experience a pulling sensation in the thigh area, but this is typically temporary and should diminish within a couple of weeks.
The possible risks and complications of laser treatment
While endovenous thermal ablation is generally safe and well-tolerated, there are potential risks and complications associated with the procedure.
These complications may include:
- Pain
- Swelling
- Bleeding
- Infection
- Deep vein thrombosis
Serious complications are rare.
Other possible effects of laser treatment include darker skin over the treated vein, a sore and inflamed vein under the skin, called phlebitis, and numbness for a time where small skin nerves lie close to the vein. Occasionally the vein does not close fully, or reopens later, and a skin burn is very rare.
It is important for patients to discuss their medical history and any concerns with Dr Desmond Ooi before undergoing endovenous thermal ablation.
Laser treatment compared with radiofrequency ablation for the same vein
There are two main types of endovenous thermal ablation used to treat varicose veins:
- Radiofrequency
- Laser
These techniques generate heat to seal the affected vein and improve blood flow. The choice between laser and radiofrequency ablation depends on individual factors and our doctor's recommendation.
The two differ in how the heat is applied. Laser energy travels along a fine fibre that is drawn back through the vein, while radiofrequency heats the vein wall in short cycles through its catheter.
Endovenous thermal ablation offers a faster recovery than traditional surgical methods. Without heat, vein glue treatment and mechanochemical ablation need no numbing fluid around the vein, although their long-term evidence is less extensive than for laser and radiofrequency. Sclerotherapy injections can treat smaller veins that remain after a vein is closed.
Dr Desmond Ooi is a General Surgeon whose clinical interest is vascular surgery
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BM (Southampton), MMed Surgery (NUS), FRCS (Edinburgh)
He received specialised vascular and endovascular training in the UK, and was formerly Patient Safety Officer at Khoo Teck Puat Hospital.
More about Dr OoiEndovenous laser ablation cost, and paying with MediSave or insurance
- Duplex ultrasound scan, one leg:
- SGD 599.50 with GST (SGD 550 before GST)
- First consultation:
- quoted when you write in
- Surgeon's fee, laser treatment of one leg:
- from SGD 5,341 (opens the Ministry of Health page)
For medically indicated procedures
MediSave claimable
Insurance claimable
What will you pay in cash?
Paying with MediSave and insurance
For varicose vein day surgery that is medically indicated, MediSave may help, and an Integrated Shield Plan may also cover it, subject to your plan and panel.
Personal
Corporate
Vascular clinics at Mount Elizabeth and Mount Alvernia
Advanced Vascular Centre, Mount Alvernia
Medical Centre D, #07-58, 820 Thomson Road
+65 6265 8820
Questions patients often ask about endovenous laser treatment
Is endovenous thermal ablation painful?
Anaesthesia is given before the procedure.
You may experience some soreness after the procedure that can be managed with pain medication.
What is the recovery time for endovenous thermal ablation?
Patients can return to their regular activities within 1 week after endovenous thermal ablation.
Can you walk after endovenous ablation?
Yes, patients can walk right after the treatment and are also recommended to do so to improve recovery.
How long should I walk after endovenous laser treatment?
A walk of 20 to 30 minutes is usually encouraged before you go home.
After that, regular walking helps, starting gently and building up over the first week.
How long does endovenous laser treatment last?
Over the following months, the body breaks down the closed vein and absorbs it.
Varicose veins can still appear later in other veins, because vein disease can progress. The chance is lower when the scan before treatment finds every significant leaking vein and each one is treated.
What are the drawbacks of endovenous laser treatment?
Because it works with heat, it needs a numbing fluid injected around the vein, and the heat can leave an area of numbness for a time where small skin nerves lie close by.
Vein glue treatment and mechanochemical ablation avoid the heat, although their long-term evidence is less extensive.
Will my blood flow normally after the procedure?
Blood flow will return to normal after endovenous thermal ablation. The body will reabsorb the treated veins, and blood will flow through healthy veins.
In fact, endovenous thermal ablation can improve blood flow by reducing the amount of blood that pools in the affected veins.
How safe is endovenous thermal ablation?
Endovenous thermal ablation is a safe treatment when done by a licensed professional.
Like any procedure, it carries some risks, which are listed on this page.
Can you get a blood clot from vein ablation?
There is a low risk of developing a blood clot from endovenous thermal ablation. The procedure should be done by a licensed professional to reduce the risk.
Is endovenous laser treatment covered by MediSave or insurance?
For varicose vein day surgery that is medically indicated, MediSave may help, and an Integrated Shield Plan may also cover it, subject to your plan and panel.
Start with a question
If you are unsure whether endovenous laser treatment suits your veins, message the clinic. You can ask before you arrange anything. Family members can also message on a patient's behalf.