Endovenous laser ablation (EVLA) has revolutionized the management of varicose veins by offering a minimally invasive alternative to traditional surgical stripping. As a mainstay treatment for superficial venous insufficiency, EVLA provides high success rates, faster recovery, and improved patient satisfaction. This comprehensive review presents an in-depth analysis of EVLA, covering its historical evolution, technical principles, patient selection, procedural steps, outcomes, complications, comparative effectiveness, and future directions. While endovenous laser therapy is widely accepted as a first-line option in many clinical settings, understanding its intricacies—from device specifics to post-procedural care—is critical for optimizing results and minimizing risks.

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