TEVLA (Total Endovenous Laser Ablation) is a modern, minimally invasive, and comprehensive method for treating varicose veins that uses laser energy to seal (ablate) affected veins. This innovative procedure combines the treatment of the main superficial trunk veins (great and small saphenous veins) as well as collateral branches and varices in a single procedure. TEVLA is an extended version of EVLA (Endovenous Laser Ablation).
Key advantages of TEVLA include
- Safety and gentleness – minimal intervention in the body, no need for incisions or stitches.
- Quick recovery – patients return to normal activities within 1–2 days.
- No hospitalization – the procedure is performed on an outpatient basis, and the patient goes home afterward.
- Aesthetic result – no scars, incisions, or bruises.
- Minimal pain – the procedure is performed under local anesthesia, and optionally under general anesthesia upon the patient’s request.
- High success rate – the sealed vein does not regenerate, and the risk of recurrence is minimal.
- Comfort during summer – the procedure can be performed year-round, even in summer months.
The TEVLA procedure generally involves these steps
- Initial vascular examination: Every patient first undergoes an ultrasound (Doppler) examination of the vessels, based on which a vascular surgeon determines if TEVLA is suitable.
- Preparation before the procedure: The injection area is disinfected, and local anesthesia is administered. The patient is conscious during the procedure, but it can also be performed under general anesthesia for maximum comfort.
- The procedure itself: Through a small puncture, the doctor inserts a thin laser fiber into the vein, which gradually releases energy and closes the vein along its entire length. After the fiber is removed, the puncture site is treated. The procedure lasts approximately 30–60 minutes, without the need for hospitalization.
- Rapid recovery: Most patients return to normal activities within 1–2 days.
Before the procedure
It is not necessary to fast; patients can have breakfast or lunch depending on the time of the procedure. It is recommended to wear comfortable clothing and bring compression stockings, which should be worn for several days after the procedure. It is essential to inform the doctor about all medications taken and any health restrictions.
After the procedure
Immediate mobility is expected, patients go home and can walk normally. Most patients return to work the next day. Strenuous sports and prolonged standing are recommended to be avoided for 1–2 weeks. Compression stockings should be worn as recommended by the doctor, usually for several days. Mild bruising or sensitivity at the treated site is common and subsides within a few days. A follow-up examination will verify that the vein is successfully closed.
Differences between EVLA and TEVLA
- EVLA (Endovenous Laser Ablation): A minimally invasive procedure where a laser fiber is inserted into the affected vein, and heat damages the inner wall of the vein, leading to its closure. It is most commonly used to treat the main superficial veins (great and small saphenous veins).
- TEVLA (Total Endovenous Laser Ablation): An extended version of EVLA, combining the treatment of main superficial trunk veins, their collateral branches, and varices in a single procedure. This procedure can be performed under local or general anesthesia.
Who is suitable for EVLA and who for TEVLA?
- EVLA is suitable for patients with a less extensive form of varicose veins who do not have complications or associated health problems.
- TEVLA is ideal for patients with more extensive varicose veins, repeated problems (recurrences), a higher risk of complications, aesthetic requirements for a scar-free result, and the need for a quick return to work or normal life.
A vascular surgery outpatient clinic in Košice is mentioned as a leading facility offering the most modern methods for treating varicose veins, including TEVLA, EVLA, CLaCS, and RFA
