Endovenous Laser Treatment (EVLT®) or Laser Vein Ablation
Endovenous Laser Treatment (EVLT®), also known as laser vein ablation, is a minimally-invasive procedure used to treat the great saphenous vein (GSV), small saphenous vein (SSV) and other superficial veins. It uses laser energy applied inside the faulty (or incompetent) vein to seal it shut. The EVLT procedure has been FDA-approved since 2002 and over 100,000 procedures have been performed. Endovenous laser treatment (EVLT) is commonly performed in a physician's office, under local anesthesia, in less than an hour, generally with rapid return to normal activity. Other names for laser vein ablation include endovenous laser ablation of the saphenous vein (ELAS or ELA), endovenous laser therapy (ELT), and endovenous laser vein system (ELVeS).
The steps of the endovenous laser treatment/laser vein ablation procedure are as follows:
- Physician (or ultrasound technologist) uses ultrasound to map out your vein
- Catheter and laser fiber are inserted (through a tiny puncture usually located at the knee) into your vein
- Local anesthesia is ‘infiltrated’ (infused) into the area around your vein
- Targeted laser energy is delivered to rapidly seal off the vein
- Patients usually are asked to walk immediately after the procedure. Walking is encouraged to stimulate reduce pressure on the veins and minimize the risk of complications.
- Compression stockings are usually prescribed for use one to two weeks following the procedure
The endovenous laser treatment (EVLT) procedure has shown success rates of 93%1 and above. Patients are usually up and walking immediately and back to normal activity within days. Side effects include possible bruising and swelling, but these typically subside with time. With proper post-operative care and the use of compression stockings and bandages, these side-effects should occur at rates similar to other endovenous techniques2. Patients may also feel a delayed tightness (or "pulling" sensation) 4-7 days after laser vein ablation. This is common and subsides over a week or so. DVT is a potential rare complication.
The endovenous laser treatment (EVLT®) procedure is usually covered by Medicare and many insurers in the United States for patients experiencing medical symptoms and who have previously tried conservative therapy (like compression stockings). Contact your insurance provider for specifics on coverage in your area.
1 Min, Khilnani, Zimmet. Endovenous Laser Treatment of Saphenous Vein Reflux: Long-Term Results. J Vasc Interv Radiol; 2003;14:991-996
2 Zimmet SE. Endovenous Laser Ablation. Phlebolymphology, 2007;14(2):51-58.
EVLT is a registered trademark of Angiodynamics Incorporated (Queensbury, NY).