EVLT - Risks, Complications, Alternatives

The advent of laser treatments has opened the door to more variation in terms of treating varicose veins. At one time it was necessary to have surgery done to rid the legs of the unsightly, gnarled, bulbous veins. Or, a person wore compression stockings to make life more bearable. While these methods are still in use, there are more advanced and less restrictive ways of dealing with varicose veins with the use of laser power.

EVLT Procedure

Endovenous laser treatment requires no incisions and is performed with a laser fiber and ultrasound visualization of the vein. The administration of a local anesthesia to numb the area where the needle penetrates is given and the area above the knee where the vein in question is located is cleaned with an antiseptic ointment or cleanser. A needle is placed in the vein and a small laser probe is inserted. The probe is discerned and its position verified on ultrasound. Once its position is confirmed, the probe is heated slowly with low energy. The vein walls become damaged and begin to shrink, eventually closing the vein, prohibiting the flow of blood. Once the vein is burned the probe is taken out and a dressing applied. A compression bandage is worn for about a week and the entire process takes about one hour in total.


Recovery is very fast and relief from the discomfort of the veins is almost immediate. Since there is no incision, there are no scars and there is minimal post operative pain. A minor soreness and bruising may occur which can be treated with OTC pain medication. Patients are encouraged to walk and get back to normal activities right after the procedure and to follow-up with the practitioner in a week or two.


There are potential complications which may arise; however, with EVLT, these are very rare. The thigh area may become mildly numb and there might be a pulling sensation for about a week after the procedure. A very mild case of phlebitis - redness and tenderness of the skin - tends to be common. This condition is normally gone in three to seven days. Very rarely there is a case of deep venous thrombosis. The best way to avoid this situation is to wear compression stockings or bandages and to walk immediately after the procedure. Mild bruising is quite common, but also resolves in a week. On rare occasions the procedure fails. This is usual due to the inability to insert the probe into the vein or the inability of the laser to destroy the vein. Most frequently, these cases involve inexperience on the part of the physician with the procedure.


Alternatively, for large veins there is surgery, which requires the use of anesthesia, incisions and ultimately scars. Recovery time is much longer and it's more painful as well. Sclerotherapy is not used to treat large veins. Ultrasound-guided mini-sclerotherapy and radio frequency electro surgery are other options which are closer in nature to EVLT.