Endovenous Laser Therapy

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Endovascular laser therapy is performed to treat unsightly and often painful varicose veins. With the help of image-guidance, your doctor will locate unhealthy veins and use lasers to stop the blood flowing into these enlarged veins. Blood is then redirected into healthy veins.

Need to Know

Nice to Know
  • Eat a light breakfast prior to arrival.
  • Stop taking aspirin or anti-inflammatory medications (NSAIDS) for five days before the procedure. If you take blood thinners such as Coumadin, your doctor may also advise you to stop taking these medcations a period of time before the procedure.
  • Please let your physician’s office know if you have any allergies to anesthesia, including lidocaine.
  • Inform your technologist if you are pregnant
  • Before your procedure, you’ll meet with your Jefferson Radiology physician for a consultation
  • You’ll be given a gown to wear during your treatment
  • You’ll be awake during the procedure and can go home after
  • No surgical incision is needed, just a small nick in the skin
  • You may feel some discomfort after the procedure, but no serious pain. This can be treated with over-the-counter pain medications.
  • You will be required to wear compression stockings for about two weeks following the procedure


How Does It Work?

Your doctor will use ultrasound imaging to locate the varicose veins and insert a catheter (a long, narrow tube) into the veins. A laser is then fed through the catheter to close off the enlarged vein, therefore redirecting blood flow to healthy blood vessels. The unhealthy veins will eventually shrink down and disappear from the skin’s surface.

What Happens — Before, During, and After?

When you arrive for your procedure a nurse will greet you and let the team know you’ve arrived. You will be brought into an exam room and asked to change into a gown. Your doctor will greet you, explain the procedure and answer any questions you may have.

You will lie on an exam table for the procedure. Your physician will place an ultrasound transducer (a wand that resembles a microphone which sends ultrasound images to a screen in the procedure room) to view the veins. After cleaning the area of your leg and covering it with a surgical drape, your physician will numb the area with a local anesthetic. You will feel a tiny pinch from the anesthesia. In some cases several injections will be needed to numb the area along the vein. This may be the most uncomfortable portion of the procedure.

Once the area is numb, your doctor will insert a catheter into the vein and continue to use the ultrasound to guide the catheter placement. You may feel some pressure as the catheter is inserted and fed into the vein but you will not feel any pain. Once in place, the laser will be inserted through the catheter to treat the unhealthy veins. Once the laser treatment is complete, the catheter will be removed. Your doctor will apply pressure to stop any bleeding but you will not require any stitches. The procedure typically takes about one hour.

Once the procedure has been completed you will be given a compression stocking to wear. This will help prevent swelling and will reduce your risk of developing a blood clot. You will be able to return to your normal activities after the procedure. To minimize your risk of blood clots you will be instructed not to sit for long periods of time following the procedure.

When you feel ready, you will be able to go home.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
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What Should I Bring?

On the day of your procedure you should:

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of endovascular laser therapy could be:

  • Effective and safe treatment of varicose veins – most patients report relief of symptoms and no visible veins.
  • Minimal or no discomfort after the procedure and fewer complications reported than traditional vein stripping procedures.
  • No scarring and no stitches required.
  • Patients are able to return to normal activities immediately after the procedure.

Risks you should be aware of include:

  • As with any procedure, there is a small risk of infection. The chance of infection requiring antibiotic treatment is less than one in 1,000.
  • There is a slight risk of damage to blood vessels, bruising or bleeding from the catheter.
  • Some bruising and soreness is reported but may be minimized by wearing compression stockings.
  • There is a rare chance of heat damage to nerves but this typically goes away over a short period of time.
  • In some cases there is an inflammation of the vein after the procedure that may cause redness and discomfort. This can usually be treated with over-the-counter pain medication. Talk to your doctor about this.
  • Rare but serious complications may include blood clots. Compression stockings help reduce this risk.

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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