Procedures

Endovenous thermal ablation (EVTA)

Massachusetts General Hospital Imaging provides endovenous thermal ablation (EVTA), a minimally invasive, image-guided treatment for varicose veins, in a caring environment using the latest technology.

Massachusetts General Hospital Imaging provides endovenous thermal ablation (EVTA), a minimally invasive, image-guided treatment for varicose veins, on the Mass General main campus in Boston. Performed by specially trained radiologists using real-time image guidance, interventional-radiology procedures such as EVTA often require smaller incisions, have fewer risks of complication, and take less recovery time than traditional surgery.

EVTA overview

  • Treats varicose veins.
  • Uses heat energy to seal off problem veins.
  • Relieves leg pain and swelling, improves appearance.
  • As a "minimally invasive" procedure, involves a smaller incision, fewer risks of complication, and less recovery time than traditional surgery.
  • We pay special attention to minimizing radiation exposure—without giving up image quality.
  • Our state-of-the-art imaging technology plays a key role in planning and performing each procedure, and on-staff physicists and engineers ensure that our machines remain in top condition.

EVTA in depth

Treatment

Endovenous thermal ablation (EVTA) is a quick, minimally invasive procedure that leaves no scar and can be performed using a local anesthetic in an outpatient setting. The heat energy damages the vein walls, shrinking them and closing the faulty vein so that the blood cannot flow through it. This eliminates vein bulging at its source. After treatment, the blood in the faulty veins will be diverted to the many normal veins in the leg.

When should I consider EVTA?

Although this procedure may be used for cosmetic purposes, it is more commonly used to help treat symptoms. Symptoms are typically due to enlarged nonfunctional veins that cause circulatory problems (venous insufficiency). Symptoms include:

  • Leg pain
  • Swelling
  • Skin irritation, sores (ulcers), and discoloration
  • Inflammation of the veins (phlebitis), resulting in painful veins or varicosities

Expertise

The interventional radiologists who perform procedures at Mass General Imaging are specialists in the area of the body and the condition under treatment, as well as the procedure itself. In addition to the training that all radiologists receive, these specialists have additional education, plus extensive real-world experience. In many cases, our doctors helped to pioneer many of the interventional treatments that we offer.

Coordinated care

Our team of interventional radiologists and nurse practitioners coordinates a patient's complete care—from imaging evaluation to post-procedure followup—maintaining a high level of communication with the patient throughout the process. In addition, Mass General Imaging works in close coordination with experts from across Mass General when necessary.

What should I expect BEFORE EVTA?

You should wear comfortable, loose-fitting clothing. You may be asked to wear a gown during the procedure. You should plan to have a relative or friend drive you home after your EVTA procedure.

What should I expect DURING EVTA?

The radiologist uses ultrasound to map out your vein. Local anesthetic is applied. A thin fiber is inserted through a tiny entry point, usually near the knee. Thermal energy is delivered to seal the faulty vein. EVTA takes less than one hour.

What should I expect AFTER EVTA?

Walking immediately after the procedure is encouraged. Normal daily activity can be resumed (just avoid rigorous activities, such as gym workouts). There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain reliever as needed.

Imaging technology enables non-surgical treatments

Department of Radiology Chairman Emeritus James H. Thrall, MD, explains how the ability to see deep inside the body has driven the development of minimally invasive methods of treatment—a trend in which Mass General Imaging has played a key role.

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