Endovenous Laser Ablation (Destruction of large varicose veins of the legs using a laser from inside the vein) Varicose veins are sometimes huge. Really large veins in the legs are often related to increased venous pressure inside superficial veins, most often the greater saphenous vein. Most large veins are associated with pain, congestion, swelling, skin changes and sometimes even bleeding. These are partly genetic, more common in women, and tend to worsen with pregnancy and being on one’s feet a lot, such as in waitressing. In addition to causing pain and swelling, these veins are unattractive. A procedure invented about the turn of the century has become increasingly popular for treatment of large leg veins and is abbreviated EVLA, endovenous laser ablation. This cool procedure dramatically and quickly reduces venous pressure, pain, swelling and the size of varicose veins. When coupled with sclerotherapy the improvement is often dramatic. This man had a dramatic reduction in pain, swelling and a dramatic improvement in appearance in just 18 days. He was working 2 days after his procedure. This procedure is often covered by Health Insurance. It is much less painful than leg stripping, less expensive and has less down time. Dr. Van Reken has had venous ablation procedures with good results in both of his legs.