Endovenous Laser Treatment

What is Endovenous Laser Treatment?

Endovenous Laser Treatment (ELT or EVLT) is a minimally invasive procedure that uses targeted laser energy to close varicose veins from the inside. Like radiofrequency ablation, ELT treats venous insufficiency by sealing the diseased vein, redirecting blood flow to healthier veins and relieving the symptoms caused by faulty vein valves.

ELT is a quick, effective alternative to traditional vein stripping surgery. The entire procedure takes about one hour, is performed in our office under local anesthesia, and allows you to return home the same day with minimal discomfort.

How Does Endovenous Laser Treatment Work?

ELT works by delivering precise laser energy to the interior wall of the affected vein, causing it to heat, collapse, and seal shut.

The Procedure

1. Ultrasound mapping: Your physician uses duplex ultrasound to visualize the affected vein and plan the treatment approach.
2. Local anesthesia: The skin at the insertion site is numbed with a local anesthetic.
3. Fiber insertion: A small optic fiber is inserted through a needle into the varicose vein under ultrasound guidance. The fiber is advanced to the treatment area.
4. Tumescent anesthesia: A dilute anesthetic solution is injected around the vein to numb the area, protect surrounding tissue, and compress the vein around the fiber.
5. Laser activation: The laser is activated, and as the optic fiber is slowly withdrawn from the vein, it delivers energy that heats the vein wall, causing it to collapse and seal closed.
6. Completion: The fiber is removed, and a small bandage is applied. No stitches are required.

After the Vein is Closed

Once the vein is sealed, blood that was circulating through the abnormal vein is naturally rerouted to other healthy veins. Over time, the closed vein is absorbed by the body and fades from view. The varicose branch veins that were fed by the treated vein gradually shrink and improve in appearance.

Who is a Candidate for ELT?

Endovenous laser treatment is appropriate for patients with:

• Varicose veins caused by reflux in the great saphenous vein or other truncal veins
• Symptoms of venous insufficiency, including leg pain, heaviness, swelling, and fatigue
• Skin changes or ulcers related to chronic venous disease
• Insufficient relief from conservative treatments such as compression stockings

Important Considerations

ELT cannot treat veins that are too small, too twisted, or too close to the surface of the skin. This means many ELT patients will also benefit from sclerotherapy to address smaller spider veins and branch varicose veins. Your vascular specialist will create a comprehensive treatment plan that may combine ELT with other procedures for the best overall results.

Benefits of Endovenous Laser Treatment

• Quick procedure: Completed in approximately one hour from start to finish
• Minimally invasive: No surgical incision — just a tiny needle puncture
• Local anesthesia: No general anesthesia required; you remain awake and comfortable
• Outpatient: Performed in our office; you go home the same day
• Minimal pain: Most patients experience very little to no pain during the procedure
• Fast recovery: Normal activities can be resumed the same day or next day
• Insurance coverage: Most insurance plans and Medicare cover ELT for symptomatic varicose veins
• Proven results: High closure rates with excellent long-term outcomes [1]

What to Expect During Recovery

Recovery from endovenous laser treatment is typically smooth and fast:

• Day of procedure: Walking is encouraged immediately. You can resume light daily activities the same day.
• First 1-2 weeks: Compression stockings should be worn as directed. Mild bruising, tenderness, or a sensation of tightness along the treated vein is normal and resolves on its own.
• Activity guidelines: Daily walking is recommended. Avoid strenuous exercise, heavy lifting, and prolonged standing for approximately two weeks.
• Follow-up: A duplex ultrasound is typically performed within the first week to confirm the vein has closed successfully.
• Ongoing improvement: Varicose vein appearance and symptoms continue to improve over several weeks to months as the body absorbs the treated vein.

Potential Risks and Side Effects

ELT is a safe procedure with a low rate of complications. Possible side effects include:

• Mild bruising and tenderness (common and temporary)
• Temporary numbness or tingling near the treated area
• Sensation of tightness or cord-like feeling along the treated vein
• Mild skin discoloration that fades over time
• Rarely, deep vein thrombosis (DVT) or skin burn

Your physician will review all potential risks and answer your questions during your consultation.

ELT vs. Other Vein Treatments

Both ELT and RFA achieve excellent closure rates and similar outcomes. Your vascular specialist will recommend the best approach based on your specific anatomy and condition.

Why Choose Preferred Vascular Group?

Our vascular specialists are experienced in all modern vein treatment techniques, including endovenous laser treatment. At Preferred Vascular Group, you benefit from:

• Comprehensive vein evaluation with state-of-the-art duplex ultrasound
• Personalized treatment plans tailored to your specific vein condition
• Experienced physicians skilled in ELT and complementary procedures
• Comfortable, office-based treatment with minimal downtime
• Eight convenient locations across Georgia and Ohio

If varicose veins are affecting your daily life, ELT may provide the relief you need. Schedule a consultation to learn whether endovenous laser treatment is right for you.

References

1. Rasmussen L, et al. “Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up.” Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2016. PubMed
2. Xie J, et al. “Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis.” Medicine, 2024. PubMed
3. Marsden G, et al. “Diagnosis and management of varicose veins in the legs: summary of NICE guidance.” BMJ, 2013. PubMed