Twenty Years’ Experience with Endovenous Laser Ablation forVaricose Veins: A Critical Appraisalof the Original Procedure
Endovenous laser ablation (EVLA) for varicose veins is conducted in an ambulatory setting using tumescent local anesthesia (TLA). Technical advancements have reduced the need for multiple incisions, re-punctures, and minimized complications such as ecchymosis and technical failures. Using a 1470-nm diode laser with a radial fiber has enhanced patient satisfaction and lowered complication rates. The appropriate administration of TLA via infusion pump has decreased nerve injury risk, administration time, and procedural pain. High ligation and stripping are now rarely indicated. Over the past 20 years, EVLA has become an effective, cost-efficient, and safe procedure with high patient satisfaction.
