What is endovenous laser treatment?

Endovenous laser treatment is a procedure that eliminates varicose veins and spider veins. Endovenous laser treatment involves inserting a laser fiber into a leg vein called the saphenous vein. The laser uses light energy that causes the affected veins to collapse and close shut. Your body then redirects the blood that used to flow through those veins to other veins.

Endovenous laser treatment is only one method used to treat varicose veins and spider veins. Discuss all of your treatment options with your doctor to understand which options are right for you. 

Why is endovenous laser treatment performed?

Your doctor may recommend endovenous laser treatment to eliminate varicose or spider veins that are large, protruding, unsightly, or causing burning, soreness, rashes or cramping.

Veins are blood vessels that carry blood from your body back to your heart. There are valves inside veins that help direct blood back to your heart. When the valves are damaged or weakened, blood can pool in your veins causing them to swell and weaken. This results in varicose veins. Varicose veins can look blue, twisted and bulging, and can be uncomfortable. Varicose veins most often occur in the thighs and calves.

Your doctor may only consider endovenous laser treatment for you if other treatment options with less risk of complications are ineffective. Lifestyle changes such as exercise, losing weight, and wearing compression stockings may help prevent varicose veins or the symptoms associated with varicose veins, such as soreness and cramping. 

Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on endovenous laser treatment. 

Who performs endovenous laser treatment?

The following specialists perform endovenous laser treatment: 

  • Dermatologists specialize in diagnosing and treating conditions of the skin, hair, nails and mucous membranes.
  • Phlebologists specialize in vein conditions.
  • Vascular surgeons specialize in the surgical treatment of blood vessel diseases.
  • Vascular and interventional radiologists specialize in the nonsurgical treatment of blood vessel and other conditions using catheter-based procedures and imaging techniques. 

How is endovenous laser treatment performed?

Your endovenous laser treatment will be performed in an office or outpatient setting. The procedure generally includes these steps:

  1. You will dress in a patient gown or wear your own loose-fitting clothing. 
  2. You will lie on a procedure table. 
  3. Your doctor will use ultrasound to identify the veins that need treatment. This involves putting ultrasound gel on your leg and moving a wand-like transducer over the skin of your leg. The ultrasound transducer and sound waves are painless.
  4. Your doctor will clean the surgical area and inject a local anesthetic where he or she will insert the laser fiber. This is typically the inside of your knee and areas along the vein.
  5. Once the area is numb, your doctor will make a small incision at the vein and insert a very thin tube called a catheter into the vein. Then your doctor will insert a thin laser fiber into the catheter and deliver laser pulses while slowly pulling the laser and catheter back out of the vein. The laser light pulses cause the affected vein to shrink and eventually shut. 
  6. Your doctor will remove the laser fiber and catheter out of your leg.  
  7. Your team will bandage the incision in your leg. Incisions generally do not need stitches. 

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel a pinch, discomfort or stinging when your doctor injects local anesthetic into your skin. You might also feel some pressure on your leg during the procedure. Tell your doctor if any discomfort does not pass quickly. 

What are the risks and potential complications of endovenous laser treatment? 

Complications of endovenous laser treatment are uncommon, but any medical procedure involves risks and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of endovenous laser treatment include: