Protocol: Endovenous Laser Ablation (EVLA)
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Because of the high volume of endovenous laser treatments we perform (among the highest in North America), and because we train other physicians in the procedure, we are able and qualified to develop our own method. To do so, we used our own research, feedback from our patients, and of course our vast experience performing the procedure.

  1. At The Vein Institute of Toronto™ you will undergo a comprehensive venous consultation by a physician, comprised of your venous history and physical exam, followed by a venous duplex ultrasound in order to assess for superficial venous reflux, rule out deep venous thrombosis and map out the anatomy of your superficial venous system. This allows us to develop a personalized treatment plan for you.
  2. If you decide to proceed with the procedure, please follow the pre-procedure instructions (page 6) and medication protocol comprised of Arnica™ and Bromelain to minimize post-procedure discomfort, bruising and pigmentation to optimize the results. An EVA kit including Arnica™ tablets/gel, Bromelain tablets and gel pack may be obtained from The Vein Institute of Toronto™.
  3. The EVA procedure is performed according to our own tested and proven protocol, which was developed by physicians from around the world (page 7).   EVA is a minimally invasive, ultrasound-guided procedure involving endovenous ablation of the affected saphenous vein.  At The Vein Institute of Toronto™, our EVA protocol using our unique micropuncture technique has produced a 99% technical success rate and 92% clinical success rate in over 2200 procedures to date.
  4. After the procedure a physician assistant will assist you to put on the required compression stockings. Please wear the Class II (30-40 mm Hg) compression stockings for the first 72 hours and then from first thing in the morning to before bed time for another 10 days. For optimal results, please follow the post-procedure instructions (page 8).
  5. You will be seen in follow-up at one and twelve weeks after the procedure or as per your personal schedule and individual requirements. At each follow-up, a venous ultrasound will be performed to confirm the treated saphenous vein is closed. Foam sclerotherapy injections (which are included as part of your procedure) will be performed for any residual branch varicose veins (page 9) at your discretion or if clinically necessary. Please bring your stockings for all follow-up appointments. All post EVA follow-ups are included as part of the procedure.
  6. At your 2 and 12 week follow-up appointments, you will be instructed on our Leg Wellness Program to improve the conditioning of your legs.

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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