Endovenous laser therapy (EVLT)

Our interventional radiologists always start with a detailed ultrasound examination. Both the deep and superficial veins are carefully evaluated. The greater and lesser saphenous veins are also carefully examined - if the saphenous veins have abnormal reflux than the patient is a candidate for endovenous laser therapy (EVLT). If the saphenous veins are normal, we will then offer ambulatory (micro) phlebectomy or sclerotherapy as the treatment. We always discuss the ultrasound findings and treatment options during a pre-procedure consultation.

What can be expected during the laser treatment?

Endovenous laser therapy is an exciting state-of-the-art, outpatient, non-surgical procedure. It usually takes less than an hour to complete. Patients are given the option of having oral or intravenous conscious sedation for relaxation. General anesthesia is not necessary. After the leg is prepped and draped and the skin anesthetized, the laser fiber is inserted into the vein through a tiny needle hole using ultrasound guidance. The laser fiber is then activated, sealing the vein closed with heat energy. A band-aid is applied to the needle hole, a compression stocking is placed on the leg and the procedure is complete!

What can be expected after the laser treatment procedure?

Because this is an outpatient procedure, patients can leave after the procedure is completed; if necessary, they can even return to work the same day. All patients are required to wear a prescription thigh-high compression stocking for two weeks after the procedure. Patients will be fitted for the stocking during their initial consultation. Minor soreness, bruising and swelling are common following the procedure; however, these symptoms should be gone after one to two weeks. Unlike the surgical procedure of vein stripping, the laser treatment is minimally invasive with a much shorter recovery period.

Are there any risks?

Endovenous laser therapy has been proven to be remarkably safe. Extremely rare reported complications include overlying skin burns, nerve injuries or blood clots developing in other untreated veins. These risks are well below 1%; we have not seen these complications in our practice to date.

What are the results?

Reports in the literature (as well as in our experience) have demonstrated a >98% success rate.

Do insurance companies cover this procedure?

The overwhelming majority of insurance companies cover endovenous laser therapy, ambulatory phlebectomy, and sclerotherapy for treatment of symptomatic varicose veins. However, not all insurance companies will cover spider vein sclerotherapy.