Endovenous Laser Treatment (EVLT) for Varicose Veins
Endovenous laser treatment (EVLT) is a procedure that uses laser heat to treat varicose veins.
Varicose veins are swollen and enlarged veins. They occur most often in the legs. Varicose veins can develop when valves in your veins become damaged. This causes problems with blood flow. Over time, too much blood collects in the veins. The veins may bulge, twist, and stand out under your skin. They can also cause symptoms such as aching, cramping, or swelling in your legs.
During EVLT, heat created using a laser is sent into the vein through a thin, flexible tube (catheter). This closes off blood flow in the main problem vein.
Getting ready for your treatment
Follow any instructions from your healthcare provider.
Tell your healthcare provider if you:
Are pregnant or think you may be pregnant
Smoke or use alcohol on a regular basis
Have other health problems, such as diabetes or kidney problems
Tell your provider about any medicines you are taking. You may need to stop taking all or some of these before the procedure. This includes:
Medicines that can thin your blood or prevent clotting (anticoagulants)
All prescription medicines
Over-the-counter medicines such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Follow any directions you’re given for not eating or drinking before the treatment.
The day of your treatment
The treatment takes 45 to 60 minutes. The entire treatment (including time to prepare and recover) takes about 1 to 3 hours. You can go home the same day. For the treatment:
You’ll lie down on a hospital bed.
An imaging method, such as ultrasound, is used to guide the procedure.
The leg to be treated is injected with numbing medicine.
Once your leg is numb, a needle makes a small hole (puncture) in the vein to be treated.
The catheter containing the laser heat source is inserted into your vein.
More numbing medicine may be injected around the vein.
Once the catheter is in the right position, it is then slowly drawn backward. As the catheter sends out heat, the vein is closed off.
In some cases, other side branch varicose veins may be removed or tied off through several small cuts (incisions).
When the treatment is done, the catheter is removed. Pressure is applied to the insertion site to stop any bleeding. An elastic compression stocking or a bandage may then be put on your leg.
Recovering at home
Once at home, follow all the instructions you’ve been given. Be sure to:
Take all medicines as directed
Care for the catheter insertion site as directed
Check for signs of infection at the catheter insertion site (see below)
Wear elastic stockings or bandages as directed
Keep your legs raised (elevated) as directed
Walk a few times a day
Avoid heavy exercise, lifting, and standing for long periods as advised
Avoid air travel, hot baths, saunas, or whirlpools as advised
Call your healthcare provider
Call your healthcare provider if you have any of the following:
Fever of 100.4°F (38°C) or higher, or as directed by your provider
Chest pain or trouble breathing
Signs of infection at the catheter insertion site. These include greater redness or swelling (inflammation), warmth, increasing pain, bleeding, or bad-smelling discharge.
Severe numbness or tingling in the treated leg
Severe pain or swelling in the treated leg
You’ll have a follow-up visit with your healthcare provider within a week. An ultrasound will likely be done to check for problems, such as blood clots. Your provider will discuss more treatments with you, if needed.
Risk and possible complications
Damage to the nerves in the treated area
Irritation or burning of the skin over the treated vein
Treatment doesn't improve the look or the symptoms of the problem veins
Risks of any medicines used during the treatment
August 29, 2017
Endovenous laser ablation for the treatment of lower extremity chronic venous disease. UpToDate, Nesbitt, Craig, et al. Endovenous ablation (radiofrequency and laser) and foam schlerotherapy versus open surgery for great saphenous vein varices. The Cochrane Collaboration. 2014;(7):3-5.
Dozier, Tennille, RN, BSN, RDMS,Sudheendra, Deepak, MD