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Endovenous Laser Treatment

By

Megan Freedman

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:

  • Allergic reaction to the local anesthetic

  • Blood clots

  • Bruising and swelling

  • Damage to deeper veins and other blood vessels

  • Infection

  • Inflammation of the remaining vein or at the incision

  • Numbness

  • Skin burns

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before the procedure and during recovery

  • Informing your doctor if you are nursing or if there is any possibility of pregnancy

  • Notifying your doctor right away of any concerns such as bleeding, fever, increase in pain, or wound redness, swelling or drainage

  • Taking your medications and wearing your compression stockings exactly as directed

  • Telling all members of your care team if you have any allergies

How do I prepare for my endovenous laser treatment? 

You are an important member of your own healthcare team. The steps you take before your procedure can improve your comfort and outcome. 

You can prepare for endovenous laser treatment by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Learning about the procedure and asking any questions you may have

  • Taking or stopping medications exactly as directed

Questions to ask your doctor

Have endovenous laser treatment can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your treatment and between appointments.

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Are there any other options for treating my varicose veins?

  • Where will my treatment take place?

  • How long will the procedure take? When can I go home?

  • What restrictions will I have after the treatment? When can I return to work and other activities?

  • How do I care for my incisions? When can I shower?

  • What assistance will I need at home?

  • How do I take my medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my endovenous laser treatment?

Knowing what to expect after endovenous laser treatment can help make your road to recovery as smooth as possible.

How will I feel after endovenous laser treatment?

You may have soreness and inflammation after endovenous laser treatment. Over-the-counter (OTC) pain medications may relieve this. Check with your doctor before using OTC pain relievers and only take them as directed. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication. 

You will probably need to wear compression stockings after your procedure to stabilize your veins and help them heal. Your doctor may encourage you to walk frequently to encourage healing.

Recovery after surgery is a gradual process. Recovery time varies depending on your general health, your age, and other factors. Full recovery takes a few days to a few weeks.

When can I go home?

Patients usually go home right after endovenous laser treatment. 

When should I call my doctor?

It is important to keep your follow-up appointments after endovenous laser treatment. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Change in alertness such as passing out, dizziness, unresponsiveness, or confusion

  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.

  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot

  • Pain that is not controlled by your pain medication

  • Unexpected drainage or pus coming out of the incision in your leg

How might endovenous laser treatment affect my everyday life?

Endovenous laser treatment will likely relieve much of the discomfort, bulging and discoloration of varicose veins. It will not prevent varicose veins from coming back, and you may need more varicose vein procedures in the future. 

You can make changes in everyday life that may help prevent or delay recurrence of varicose veins including:

  • Exercising

  • Losing weight

  • Wearing compression stockings

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 12, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Endovenous Laser Treatment. Venacure EVLT. http://venacure-evlt.com/varicose-veins/treatments/endovenous-laser-therapy/.
  2. Frequently Asked Questions. The American College of Phlebology. http://www.phlebology.org/patientinfo/faq.html.
  3. Treatment Options. The American College of Phlebology. http://www.phlebology.org/patientinfo/treatment.html.
  4. Varicose Vein Treatment (Endovenous Ablation of Varicose Veins). RadiologyInfo.org. http://www.radiologyinfo.org/en/info.cfm?pg=varicoseabl.
  5. Varicose veins and spider veins fact sheet. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.cfm
  6. What Are Varicose Veins? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/vv/.

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