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Varicose veins are swollen and enlarged veins. They occur most often in the legs. Varicose veins can develop when valves in the veins become damaged. This causes problems with blood flow. Over time, too much blood pools in the veins. The veins may bulge, twist, and stand out under the skin. They can also cause symptoms such as aching, cramping, or swelling in the legs. A treatment called endovenous laser treatment (EVLT) can help. During the treatment, heat created using a laser is sent through a catheter (thin, flexible tube), which closes off blood flow in the main problem vein. This sheet explains how the treatment is done.
Prepare as you have been told. Tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before the treatment. Also, follow any directions you’re given for not eating or drinking before the treatment.
The treatment takes 45-60 minutes. The entire treatment (including time to prepare and recover) takes about 1-3 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 medication.
Once the leg is numb, the vein to be treated is punctured with a small needle.
The catheter containing the laser heat source is inserted into the vein.
More numbing medication may be injected around the vein.
Once the catheter is in the correct position, it is then slowly drawn backward. As heat is emitted from the catheter, the vein is closed off.
In some cases, additional side branch varicose veins may be removed or tied off through several small 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 the leg.
Once at home, follow all the instructions you’ve been given. Be sure to:
Take all medications 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 daily.
Avoid heavy exercise, lifting, and standing for long periods as advised.
Avoid air travel, hot baths, saunas, or whirlpools as advised.
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Chest pain or trouble breathing
Signs of infection at the catheter insertion site, such as increased redness or swelling, warmth, worsening pain, bleeding, or foul-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 doctor within a week. An ultrasound will likely be done to check for problems, such as blood clots. Your doctor will discuss further treatments with you, if needed.
Damage to the nerves in the treated area
Irritation or burning of the skin over the treated vein
Failure of the treatment to improve the appearance or symptoms of the problem veins
Risks of any medications used during the treatment