Q) Endovenous Laser Ablation (EVLA) of varicose veins is best suited for patients:
A. With needle phobia B. With thrombophlebitis C. With excessive tortuosity of the vein D. With primary varicose veins
Ans d
EVLA is thermal ablation of varicose veins in which laser fiber is inserted in the lumen and ablation is done from inside. It is a good modality for primary and recurrent varicose veins and work in both long and short segments.
This treatment is not effective in cases where there is needle phobia or the veins are having excessive tortuousity or thrombophlebitis. This procedure is done under ultrasound guidance and wire is passed from the superficial to the deep veins.
Tumescent local anesthesia also helps
A. Needle phobia – EVLA requires multiple needle sticks (tumescent anesthesia), making this option inappropriate.
B. Thrombophlebitis – Active inflammation or thrombosis is a relative contraindication to EVLA.
C. Excess tortuosity – Makes catheter navigation difficult; EVLA is less suitable.
D. Primary varicose veins – Ideal candidates, especially with straight vein anatomy and valvular incompetence.
