The EVA Procedure
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  1. Please arrive AT LEAST 60 MINUTES before your procedure time, to allow for proper preparation before the procedure. On arrival, you will be asked to change into a procedure gown and remove your trousers or shorts leaving your undergarments and socks on.
  2. A local anesthetic cream will be applied to the area to be treated. This should be applied at least 60 minutes before your procedure to maximize effectiveness. You will also be given an oral sedative (Ativan) and pain killer (Oxycodone) at your discretion to minimize discomfort during the procedure.
  3. A pre-treatment photograph will be taken for to act as a baseline for your chart. A repeat mapping venous ultrasound will be performed. A tourniquet will be applied to your leg, in a standing position.
  4. You will then lie down on the treatment table and a cleaning solution will be applied on the leg(s) to create a sterile field for treatment. Sterile drapes will be placed around the treatment area (All materials used are sterile and disposed after single use).
  5. Local anesthetic (“freezing”) will be injected at the vein entry site. A needle is placed through the skin using ultrasound guidance into the vein to be treated. At The Vein Institute of Toronto™ we utilize a unique micropuncture technique to maximize success and minimize your discomfort. A guidewire will be placed through the needle into the vein. You may feel mild discomfort as the wire is being positioned. A vascular sheath (tube) will be placed over the guidewire and positioned at the junction of the superficial and deep venous system using ultrasound guidance. The ablation device will be placed through the sheath to the correct position.
  6. Branch vein sclerotherapy for your enlarged varicose veins will also be performed at the same sittingwith foam Sotadecrol solution under light or ultrasound guidance. Pigmentation can occur after sclerotherapy in 2-4% of patients. The pigmentation usually resolves in 6-10 weeks with our post treatment protocol.
  7. Tumescent anesthetic using a special mechanical pump, will be applied around the vein, to increase the effectiveness of the ablation, and minimize your discomfort (only for laser or radiofrequency). The ablation device is then activated and pulled back along the vein. The ablation device is activated for a period of approximately 5 minutes. For the safety of patients and staff, we utilize and fully adhere to ablation safety protocols. After the catheter is removed, a small antibiotic dressing is placed on the skin, in order to prevent infection and promote healing.
  8. Immediately after the treatment, dressings and support stockings will be applied to the treated area on your leg(s). We suggest you walk for five minutes after the procedure, before leaving the clinic to promote deep venous circulation.

Endovenous laser ablation (EVLA) is also known as endovenous laser treatment (EVLT). The two terms are interchangeable and refer to the same treatment.

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