Endovenous Laser Ablation (EVLA)
What is Endovenous Laser Ablation (EVLA) ...
Endovenous Laser Ablation (EVLA) is an in-clinic procedure used to treat larger varicose vein disease by closing a faulty superficial leg vein that is allowing blood to flow the wrong way (venous reflux). A fine laser fibre is positioned inside the target vein using ultrasound guidance, then controlled laser heat is delivered along the vein to seal it closed.
Once the refluxing vein is closed, blood is redirected into healthier veins. This can reduce the pressure that contributes to bulging varicose veins and may improve symptoms such as aching, heaviness, swelling, cramping, and leg fatigue in suitable patients.
How does it work ...
A refluxing superficial vein is treated from the inside. Ultrasound is used to guide the placement of a fine laser fibre into the target vein. Local anaesthetic is used for comfort, and local fluid is usually placed around the vein to reduce discomfort and protect surrounding tissues. Laser energy is delivered along the vein as the fibre is withdrawn, causing the vein to collapse and seal. Blood is redirected into healthier veins, and the treated vein gradually settles over time.
concerns EVLA can address ...
Varicose veins often develop from reflux in the main superficial leg veins, commonly referred to as the saphenous vein pathways. Treating these “feeder” veins can reduce the pressure that drives visible varicose branches closer to the surface.
Spider veins can occur on their own, but they can also appear alongside deeper reflux. An assessment helps confirm whether visible surface veins are part of a bigger underlying vein problem.
EVLA may help if you are concerned about:
- Large, bulging varicose veins in the legs
- Aching, heaviness, throbbing, swelling, cramps, or restless legs that worsen through the day
- Varicose veins that keep returning, depending on the underlying cause
- Vein-related skin changes caused by long-term pressure, where treating reflux is clinically appropriate
benefits of EVLA ...
EVLA is designed to treat the underlying reflux that often drives larger varicose veins. Potential benefits may include:
- Targets the refluxing ‘feeder’ vein that contributes to varicose veins and symptoms
- Performed in the clinic under local anaesthetic with ultrasound guidance
- A small access point rather than large incisions
- Many patients return to routine activities quickly, with recovery varying between individuals
- Can be combined with other vein treatments as part of a staged plan when needed
Results vary, and no specific outcome can be guaranteed.
How EVLA fits with sclerotherapy and surface vein treatment ...
Varicose vein care often involves treating both the underlying reflux and the visible surface veins. Treating the feeder vein first can reduce pressure in surface veins and help improve the overall result. Your plan is tailored based on ultrasound findings and your priorities.
A common staged approach is:
- Step 1: EVLA to close the refluxing feeder vein that is driving larger varicose veins
- Step 2: Sclerotherapy (including ultrasound-guided sclerotherapy where appropriate) to treat remaining surface varicose branches, reticular veins, or spider veins
Am I a suitable candidate ...
Suitability is confirmed through consultation and duplex ultrasound mapping. You may be suitable if you:
- Have varicose veins and/or symptoms that suggest venous reflux
- Have reflux confirmed on duplex ultrasound in a vein that is appropriate to close
- Are medically suitable for an in-clinic procedure under local anaesthetic
- Can follow aftercare guidance and attend follow-up as advised
- Have realistic expectations and understand additional treatment may be recommended for residual surface veins
Is there any downtime ...
Recovery varies between individuals. Many people return to routine activities quickly, but bruising, tenderness, tightness, and a pulling sensation along the treated vein can occur while it settles. Your practitioner will provide tailored instructions based on your vein map and overall plan.
Aftercare often includes:
- Walking daily, especially in the first week
- Wearing compression stockings if advised, with duration varying by clinician and vein pattern
- Avoiding strenuous exercise for a short period, especially if bruising or tenderness is present
- Avoiding high heat exposure early on if advised
what the treatment involves ...
Your treatment starts with a consultation and duplex ultrasound mapping. This confirms which vein is refluxing, whether EVLA is appropriate, and whether other treatments may be needed as part of a staged plan. If surface varicose branches or spider veins remain, follow-up treatment may be recommended once the underlying reflux has been treated.
On the day, EVLA commonly involves:
- Ultrasound guidance throughout
- Local anaesthetic
- A small access point to position the laser fibre inside the vein
- Laser treatment is delivered along the targeted vein segment
- A small dressing at the access site, with walking encouraged soon after
do I require a GP referral ...
A GP referral is not required for this treatment.
recovery ...
Recovery varies between individuals. Many people return to routine activities quickly, but bruising, tenderness, tightness, and a pulling sensation along the treated vein can occur while it settles. Your practitioner will provide tailored instructions based on your vein map and overall plan.
Aftercare often includes:
- Walking daily, especially in the first week
- Wearing compression stockings if advised, with duration varying by clinician and vein pattern
- Avoiding strenuous exercise for a short period, especially if bruising or tenderness is present
- Avoiding high heat exposure early on if advised
potential risks and complications ...
As with any treatment, Endovenous Laser Ablation involves potential risks. During your consultation, your practitioner will discuss possible risks and complications as part of the informed consent process. Visit our Risks and Complications page for more information. Potential side effects and complications may include:
- Bruising, tenderness, tightness, and local discomfort
- Inflammation in a treated surface vein as it settles
- Temporary numbness or nerve irritation in certain leg regions
- Skin irritation or colour change (uncommon)
- Skin burn (rare)
- Clot-related complications, such as deep vein thrombosis (uncommon but serious)
procedure fees ...
A personalised quote is provided after consultation and ultrasound mapping. Fees vary depending on:
- Which vein(s) are being treated, and the extent of reflux on ultrasound
- Whether additional treatment is recommended for surface veins
- Your overall plan and follow-up requirements
medicare eligibility ...
Medicare eligibility depends on whether treatment is considered medically necessary and whether strict criteria are met under relevant item numbers. Cosmetic-only vein treatment is often not Medicare-rebatable. Eligibility is assessed case by case.
FAQs ...
Do I need an ultrasound before EVLA?
Yes, duplex ultrasound mapping is usually required to confirm reflux and identify the feeder vein causing the varicose vein pattern. This guides whether EVLA is appropriate and what should be treated.
Is EVLA done under general anaesthetic?
EVLA is usually performed under local anaesthetic in clinic. Most patients stay awake, and comfort measures are tailored to the individual.
What does the 'laser' actually do inside the vein?
The laser delivers controlled heat inside the vein wall, which causes the vein to collapse and seal. Blood is then redirected through other healthy veins.
Will EVLA treat every visible vein on my leg?
EVLA treats the main refluxing feeder vein. Some surface veins reduce after pressure is lowered, while others may need additional treatment depending on size and location.
Why do some people still need sclerotherapy afterwards?
Sclerotherapy can treat leftover surface varicose branches, reticular veins, or spider veins once the feeder vein is addressed. This staged approach helps treat both root cause and surface appearance.
How do I know if my spider veins are linked to a bigger problem?
Spider veins can occur on their own or alongside deeper reflux. An assessment and ultrasound mapping can clarify whether underlying reflux is present and whether treating the feeder vein is important.
What is the difference between EVLA and surgical vein stripping?
EVLA closes the vein from the inside using ultrasound guidance and a small access point, while vein stripping physically removes the vein. EVLA is commonly used as a modern option for suitable reflux patterns.
Is there a risk of nerve irritation?
Temporary numbness or nerve irritation can occur in certain leg regions, depending on which vein segment is treated. Your clinician will explain this risk if it is relevant to your vein map.
What should I avoid straight after EVLA?
Most plans include regular walking and avoiding strenuous exercise for a short period. Your clinician will also advise on heat exposure, compression, and other aftercare based on your situation.
Can EVLA help leg symptoms even if I’m not worried about appearance?
If your symptoms are linked to venous reflux confirmed on ultrasound, treating the refluxing feeder vein may reduce symptoms such as aching, heaviness, swelling, or fatigue. Results vary.
What happens to the closed vein over time?
The closed vein remains sealed and gradually becomes less prominent as it settles. The body adapts by redirecting blood flow through healthier veins.
Can varicose veins come back after EVLA?
The treated vein is intended to stay closed long term, but new varicose veins can develop over time due to ongoing valve weakness or new reflux in other veins. Follow-up helps manage recurrence and new concerns early.
why choose me clinic ...
With over 35 years of experience in plastic surgery, aesthetic cosmetic medicine, and skin rejuvenation, Me Clinic is built around a simple priority: patient-first care.
We take time to understand you as an individual and curate an approach that feels meaningful and appropriate for your needs. We listen, we care, and we support you through your journey — from consultation through to aftercare.
Our Phlebologist / Vein Doctor can advise on suitable options to address your concerns. In an ever-evolving field, we focus on evidence-informed care and contemporary treatment options, with suitability always assessed on an individual basis.
Practitioners who perform Endovenous Laser Ablation (EVLA) at Me Clinic …
Book your evla consultation ...
If you are considering Endovenous Laser Ablation (EVLA), a consultation with our Phlebologist / Vein Doctor is your opportunity to discuss your symptoms or vein concerns, learn about suitable options, and understand what your personalised plan may involve.
Vein treatment commonly involves an initial assessment, and if treatment is suitable, your procedure(s) are typically booked for a later date. To begin your journey, call 1300 852 050 or enquire via our contact form.
We look forward to hearing from you soon and answering any further questions you may have.