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Introduction To Endovenous Laser Treatment

Lasers have been used for numerous medical applications throughout the body. Recently, a novel technique utilizing laser energy delivered endovenously (directly inside the vein) has been developed to treat varicose veins. An 810 nm diode laser will be used to deliver the laser energy via a small laser fiber.

EVLT Schematic of Laser Fiber in Vein

Endovenous laser treatment is performed under local anesthesia in the doctor's office. There is little to no scarring and a relative short recovery period after the procedure. The procedure is called Endovenous Laser Treatment (EVLT) or Endovenous Laser Ablation (EVLA); it is an outpatient procedure, which means you can resume your normal activities almost immediately. This is a relatively new FDA approved treatment offered by very specialized centers such as Cornell University in New York, the American Vein Institute in Washington, D.C., and the American Vein And Aestheteic Institute in Beverly Hills.

Description of The EVLT Procedure

Your doctor will perform a duplex ultrasound examination using a machine that allows the doctor to visualize the blood vessels and record their size and shape. He will "map" out the venous system so he can know where all the leaky points are. Photographs of the treatment areas will be taken.


During the procedure, you will be given special eye goggles to protect your eyes against accidental exposure to laser light. Next, the treatment area will be anesthetized with a common skin anesthetic, Lidocaine. A sterile fiber will be inserted into the vein and positioned under ultrasound guidance. Laser energy will be delivered to selectively treat the target vein, usually the Greater Saphenous Vein or the Lesser Saphenous vein. A compression stocking will be applied and must be worn for at least one week following treatment.

Graphic of EVLT (Endovenous Laser Treatment) of Varicose Vein

You will return to the office in 3 to 7 days and the doctor will re-examine the treated area. Doppler and duplex ultrasound evaluation will be done and additional photos may be taken. Sometimes further touch up treatment with compression sclerotherapy (injections) may also be needed.

Risks Of EVLT

There are several uncommon local side effects that could occur with EVLT. These include:

  • Bruising
  • Discoloration
  • Inflammation


They are temporary and will usually resolve in a few weeks to a few months.

What If I Don't Treat My Varicose Veins?

The potential complications of not undergoing treatment are most often limited to merely a worsening of the condition with an increase in the number of veins or enlargement in the existing veins. In cases of large varicose veins, spontaneous superficial phlebitis or bleeding may occur. Patients with varicose veins associated with underlying venous insufficiency may develop:

  • Ankle swelling
  • Skin changes
  • Eczema
  • Hyperpigmentation
  • Ulceration
  • There is an increased risk of getting blood clots if you have varicose veins

Many patients opt for treatment to have healthier better looking legs.

Alternative Treatments for Varicose Veins

Since varicose veins and spider veins are not necessarily life threatening, treatment is not mandatory. Some patients may get adequate relief of symptoms by wearing graduated compression stockings. Alternative treatments for varicose veins include surgery, ambulatory phlebectomy, ultrasound-guided sclerotherapy (Injections), bipolar radiofrequency (Closure®), or a combination of these treatments.

Benefits of Treating Varicose Veins

The potential benefits from the procedure are reduction in the size or complete closure of the treated varicose veins. This should give you improvement in your symptoms associated with the varicose veins. Your circulation may improve and you will have healthier better looking legs.