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Most varicose veins are not a surface problem. They are the visible end of a failing valve higher up the leg, usually in the saphenous vein, that lets blood fall backward instead of returning to the heart. Treating the bulge without treating the source is why veins come back.
Endovenous laser ablation (EVLA), also called endovenous laser therapy or EVLT, closes that faulty vein from the inside. Under ultrasound guidance and local freezing, a thin laser fibre is passed into the diseased vein through a single pinhole in the skin. Controlled laser energy seals the vein shut, blood immediately reroutes through healthy deep veins, and the closed vein is absorbed by the body over the following months.
There is no hospital stay, no general anesthetic, and no stitches. You walk out of our Southland SE clinic the same day. International clinical practice guidelines now list endovenous thermal ablation ahead of traditional vein stripping as the preferred treatment for saphenous reflux.
At Calgary Vein & Laser, EVLA sits alongside sclerotherapy, echosclerotherapy and diagnostic ultrasound under one roof, so the deep source and the surface veins can be treated as one plan rather than passed between clinics.
EVLA does not remove the vein and does not require an incision. It works by delivering a precise, controlled dose of laser energy to the inside wall of the diseased vein, which causes the vein to contract, seal and shut down permanently.
A duplex ultrasound scan traces exactly which vein segments have failed valves. This is the step that separates treating the cause from treating the appearance, and it dictates the entire plan.
A single needle puncture below the faulty segment allows a fine catheter carrying the laser fibre to be threaded up inside the vein, positioned to the millimetre under live ultrasound.
Dilute local anesthetic is placed in a sleeve around the vein. It numbs the area completely and forms an insulating cushion that shields skin, nerves and surrounding tissue from the heat.
The laser is activated and drawn slowly back down the vein, sealing it along its length. The pinhole is covered with a small dressing. No stitches, no scar, and you walk immediately afterward.
Once the diseased vein is closed, blood does not pool in it any longer. Circulation redirects through the deep venous system, which is where the majority of return flow already travels, and the sealed vein is gradually broken down and absorbed. The heaviness, aching and swelling that come from venous reflux usually improve within weeks.
EVLA is designed for one specific problem: truncal venous reflux. That means a large vein, most often the great or small saphenous vein, has failed valves and is allowing blood to flow the wrong way down the leg. It is not the right tool for isolated spider veins, which respond better to sclerotherapy or surface laser treatment.
Signs that reflux, not just cosmetics, may be driving your veins:
This list is a guide, not a diagnosis. Suitability is decided at your consultation, after ultrasound, by the physician who would perform the procedure. If EVLA is not the right answer for your legs, we will tell you so and explain what is.
Your first visit is a physician assessment combined with a duplex ultrasound of the leg. We map the venous anatomy, measure where and how badly the valves are leaking, and confirm the deep system is healthy.
You leave knowing whether you have true venous reflux, whether EVLA is indicated, what the treatment plan and cost would be, and what results are realistic for your legs.
The leg is cleaned and draped, the vein is accessed through a single needle puncture, and local anesthetic is placed around the vein under ultrasound. Most patients describe the freezing as the only part they really feel.
Laser energy is then delivered as the fibre is withdrawn along the vein. A dressing and a compression stocking go on, and you get up and walk before you leave. Plan roughly two hours in clinic including preparation and aftercare.
Walking is encouraged right away and is genuinely part of the treatment, because it keeps the deep veins moving. You wear your compression stocking as directed, typically continuously at first and then during the day.
Expect some tightness, tenderness or a firm cord along the treated vein, and possible bruising. Avoid heavy lifting, hot tubs and long periods of sitting still.
Most short term effects fade over one to two weeks. Regular exercise is generally resumed within this window on your physician's advice, and many patients notice leg heaviness easing well before the veins themselves look different.
A follow up ultrasound confirms the treated vein has closed and the deep system remains clear. This scan is not optional in our protocol, because closure is the whole point of the procedure and it should be verified rather than assumed.
Once the source is closed, any remaining surface varicosities or spider veins are usually finished with sclerotherapy or echosclerotherapy. Treated in this order, results last longer and fewer sessions are needed.
| Endovenous Laser Ablation | Sclerotherapy | Vein Stripping Surgery | |
|---|---|---|---|
| Best suited to | Large truncal veins with confirmed valve failure, usually the saphenous vein | Spider veins and smaller surface varicosities | Historically used for the same truncal veins EVLA now treats |
| Treats the underlying cause | Yes, it closes the refluxing vein at its source | Partly, when guided by ultrasound; surface sclerotherapy alone does not | Yes, by physically removing the vein |
| Anesthetic | Local anesthetic only | None required | General or spinal anesthetic |
| Setting | In office, no hospital admission | In office | Hospital operating room |
| Incisions | One needle puncture, no stitches | Fine needle injections | Incisions at the groin and along the leg, stitches required |
| Typical procedure time | 30 to 60 minutes | 15 to 45 minutes per session | 60 to 90 minutes plus recovery room |
| Return to activity | Walking immediately, most normal activity within 24 to 48 hours | Immediate | Commonly one to three weeks off normal routine |
| Sessions usually needed | One per treated vein | Several, spaced weeks apart | One |
| Scarring | None expected from a pinhole entry | None | Visible surgical scars |
| Current guideline position | Recommended ahead of surgery for saphenous reflux | Recommended for surface veins, and after truncal treatment | Reserved for cases unsuitable for endovenous options |
These treatments are partners, not rivals. The most durable outcome for significant varicose veins is usually EVLA to close the failing source vein, followed by sclerotherapy or echosclerotherapy to clear what remains on the surface. Because Calgary Vein & Laser performs diagnostic ultrasound, EVLA and injection treatments in the same clinic, that sequence can be planned and delivered as one course of care.
Every EVLA plan starts with duplex ultrasound, not a visual guess. We treat the vein that is actually failing, which is the single biggest factor in whether results hold.
Ultrasound imaging, EVLA, sclerotherapy, echosclerotherapy and compression therapy are all delivered here. You are not referred out mid-course and handed between clinics.
Your assessment, your procedure and your follow up scan are handled by our physician team, in the same clinic, with continuity from first consult to final result.
A follow up ultrasound verifies the treated vein is sealed and the deep system is clear. If anything needs addressing, we find it early rather than months later.
If your veins would do better with sclerotherapy alone, or if EVLA is not appropriate for you, we will say so. A treatment that is not indicated is not a treatment we recommend.
A long standing dermatology and vein practice in Southland SE, treating Calgary legs for years across both the medical and cosmetic sides of vein care.
Book a vein assessment and find out whether the veins on the surface are being driven by reflux underneath. You will leave with an ultrasound based answer and a clear plan.
Book A ConsultationCall 403-252-4410Endovenous laser ablation is a minimally invasive treatment for varicose veins caused by venous reflux. Using ultrasound guidance and local anesthetic, a thin laser fibre is passed into the faulty vein through a single needle puncture. Laser energy heats and seals the vein from the inside, blood reroutes through healthy deep veins, and the closed vein is gradually absorbed by the body. It is also called endovenous laser therapy or EVLT, and it has largely replaced surgical vein stripping for saphenous vein reflux.
EVLA and EVLT are two names for the same treatment. EVLA stands for endovenous laser ablation and EVLT for endovenous laser therapy, and the terms are used interchangeably.
Radiofrequency ablation is a closely related procedure that uses radiofrequency energy instead of laser light to heat and seal the vein. Both are endovenous thermal ablation, both are done in office under local anesthetic with ultrasound guidance, and clinical guidelines treat them as comparable first line options for saphenous reflux. Which energy source suits a given vein depends on its size, depth and course, and is decided at your assessment.
Most patients report little or no pain while the vein is being treated, because the leg is fully numbed first. The part people usually notice is the local anesthetic going in, which feels like brief stinging or pressure. Afterward it is common to have tenderness, tightness or a firm cord along the treated vein for one to two weeks. Over the counter pain relief and walking are typically all that is needed.
The laser portion itself usually takes 30 to 60 minutes for one vein. Allow approximately two hours in clinic in total, which covers preparation, ultrasound mapping on the day, the procedure, and aftercare including fitting your compression stocking. You are up and walking before you leave.
Recovery is short. You walk immediately after the procedure and most people return to desk work the same day or the next. Walking is actively encouraged because it keeps the deep veins flowing.
Heavy lifting and strenuous exercise are usually paused for the first several days, with most patients back to full training within one to two weeks depending on their physician's advice. Long flights and long road trips are typically avoided for several weeks. Compression stockings are worn as directed during this period.
Endovenous laser ablation is generally not an insured service under Alberta Health Care when performed for varicose veins, so it is usually paid privately. Some extended health or employee benefit plans contribute, particularly where symptoms such as swelling, skin changes or ulceration are documented, so it is worth checking your plan.
Because the fee depends on how many vein segments need treatment and what surface work follows, we quote your exact cost in writing at your consultation, after the ultrasound has shown what is actually required. There are no surprise charges added later. Please contact our Southland SE clinic for current fees and payment options.
The common effects are minor and temporary: bruising, tenderness, tightness or a firm cord along the treated vein, and occasionally mild numbness or tingling in a patch of skin. These usually settle within one to two weeks.
Less common risks include skin burn, persistent nerve irritation, superficial phlebitis, infection at the entry site, and clot extending into the deep venous system. Serious complications are uncommon with ultrasound guided technique and correct patient selection. Your physician will review the specific risks that apply to you, and to your medical history, before you consent to treatment.
A vein that has been successfully closed does not reopen in most patients, and published long term follow up of endovenous laser ablation shows high durable closure rates with lower recurrence than traditional stripping.
What can happen over the years is that a different vein develops reflux, because the underlying tendency toward venous insufficiency does not disappear. That is new disease rather than failure of the original treatment. Regular walking, weight management, avoiding long static standing or sitting, and wearing compression when advised all reduce that risk. We also confirm closure with a follow up ultrasound rather than assuming it.
No. The veins treated with EVLA are superficial veins that have already stopped working properly. Because their valves have failed, they are moving blood the wrong way rather than returning it to the heart. Roughly ninety percent of venous return from the leg travels through the deep venous system, which is unaffected by the procedure. Closing a refluxing superficial vein improves overall circulation in the leg rather than reducing it. Your physician confirms the deep system is healthy on ultrasound before proceeding.
A referral is not required to book a vein consultation with us. You are welcome to contact the clinic directly to arrange an assessment. If you already have a referral from your family physician, or previous ultrasound reports, bring them along as they help build the picture. We are happy to send a summary back to your family doctor when you would like us to.
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Take the first step toward confidence! At Calgary Vein & Laser, we provide advanced treatments to improve vein health and enhance skin radiance. Rid yourself of varicose veins and rejuvenate your skin's complexion by booking your free consultation today—your journey to healthier veins and radiant skin starts here!
