endovenouslaser

Endovenous laser therapy (EVLT), also called endovenous laser ablation (EVLA), is a minimally invasive treatment for varicose veins and venous insufficiency. A catheter is inserted into an incompetent truncal vein, usually the great or small saphenous vein, under ultrasound guidance. Laser energy is delivered from inside the vein to seal it shut.

During the procedure, the patient receives tumescent anesthesia along the target vein. A thin laser fiber is advanced to just below the saphenofemoral or saphenopopliteal junction. As the fiber is slowly withdrawn, laser energy heats the vein wall, causing collagen contraction and eventual closure of the treated segment.

Different wavelengths and fiber designs have been used; historical systems used 810–980 nm lasers, while more recent devices employ wavelengths around 1320–1470 nm or 1500 nm with radial-emitting fibers. The goal is uniform heat distribution while reducing complications and post-treatment pain.

EVLT is effective for many patients and generally offers quicker recovery and less morbidity than conventional vein stripping. Most patients resume normal activities within days. Potential risks include adjacent nerve injury, superficial or deep vein thrombosis, phlebitis, skin burns, pigmentation changes, and recurrence of varicosities. Compression stockings are commonly advised for several weeks.

EVLT competes with other endovascular and non-surgical options, such as endovenous radiofrequency ablation, sclerotherapy, and microphlebectomy. Choice of treatment depends on vein anatomy, patient preference, and operator experience. Long-term outcomes depend on vein anatomy, lifestyle factors, and adherence to post-procedure care.