Endovenous laser treatment (EVLT) is a quick, minimally invasive laser procedure that has shown a 98% success rate in providing relief from painful and unsightly legs to people suffering from varicose veins. Varicose veins do not function properly and do not return blood back to the heart. The pressure that causes these veins to balloon out can also eventually damage normal surrounding tissue and overlying skin. EVLT is used to seal off defective or diseased feeder veins, eliminating the source of surface varicose veins. This treatment is very safe and effective and takes approximately an hour to perform.
Endovenous Laser Treatment FAQs
Who should have this procedure?
If you have varicose veins, you may be a candidate for EVLT. To find out whether you might benefit from EVLT, call our office to schedule a consultation with one of our physicians to assess your treatment options. You will then have an ultrasound exam of your veins for proper diagnosis of your venous condition.
How is EVLT performed?
This procedure is performed under local anesthesia in our comfortable outpatient environment. Using ultrasound, the physician maps out the vein(s) to be treated with a marker. The leg is then washed and prepared for treatment. Depending on the segment of vein to be treated, a local numbing cream is applied either just above the ankle or just above the knee. A small laser fiber is inserted into the diseased vein through a needle. A local anesthetic is administered around the vein to protect the surrounding body tissues. The laser energy is then delivered as the fiber is slowly withdrawn. This causes the vein to collapse and eventually dissolve into surrounding body tissue.
How does the procedure work?
Controlled laser energy is delivered to the inside of the damaged vein. This energy damages the vein walls, shrinking and closing the diseased vein, preventing blood flow and further reflux. Following treatment, blood will be diverted to normal veins in order to make its way back to the heart. This redistribution of blood flow should improve blood circulation in the treated area. Improvement in circulation results in a reduction of the symptoms of fatigue and heaviness in the area.
What can I expect after the procedure?
Following the procedure, a bandage and a compression wrap are placed on the treated leg. You will be asked to walk for at least 20 minutes immediately following your treatment. A prescription-strength compression stocking will need to be worn for about two weeks following the procedure to achieve maximum healing and results. Most people are able to return to normal activities of daily living immediately, although avoiding exercise for two weeks following the treatment is encouraged to promote healing. It is common to have some discomfort and bruising after this procedure. Patients sometimes report a pulling sensation in the thigh area. Discomfort is usually managed by an over-the-counter medication, but a prescription pain killer may be prescribed if needed.
What are risks and side effects of this procedure?
As with all medical procedures, there are some risks associated with EVLT. There is a small risk of bleeding, infection, allergic reaction to local anesthetic, and injury to other tissues. These risks are quite small. Any type of venous intervention can be associated with blood clot formation. While the occurrence of this is rare, a clot does have the potential to spread to the main vein in your leg. Your physician will check for this at a follow-up appointment using color flow ultrasound. Our physicians have had less than 1% of their treated patients develop this problem, and it is generally treated with blood thinners.
Does insurance cover EVLT?
Many insurance carriers (including Medicare) do provide coverage for EVLT. Unfortunately, not everyone is a candidate for coverage. Carriers will cover the procedure only when deemed medically necessary. Patients must demonstrate symptomatic venous reflux disease to be considered for coverage. Symptoms associated with venous reflux disease are: pain, swelling, leg cramps, ulcers, bleeding from varicosities, etc. Patients are also required to try conservative treatment before being considered for coverage. Insurance companies will also want to see ultrasound results to determine the presence of reflux in the diseased vein(s). You may find it helpful to contact your insurance company if you have further questions about coverage.