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Is endovenous laser ablation painful?

Endovenous Laser Ablation

Images courtesy of
Steven E. Zimmet, MD

Endovenous laser ablation is a form of varicose vein treatment for veins located beneath the skin’s surface that are not working properly due to malfunctioning valves. The procedure, sometimes called endovenous laser treatment, is performed under mild local anesthesia. Patients may undergo endovenous laser ablation in an outpatient setting. Endovenous laser ablation is a safe alternative to surgical vein stripping because the attending physician does not need to make any surgical incisions during the procedure. Endovenous laser ablation is most often used to remove dysfunctional accessory veins, including the small and great saphenous veins. Doctors perform the treatment using varicose veins removal systems such as the Endo Laser Vein System.

Physicians often recommend that the laser removal of underlying veins with endovenous laser ablation be combined with other procedures such as sclerotherapy and/or microphlebectomy to treat varicose veins nearer to the skin’s surface.

Patients are typically numbed with a local anesthetic before the laser ablation begins. If needed, the physician may also administer medication to help a patient to relax. A needle, tiny laser fiber and sheath are then placed into the damaged vein by way of a small needle puncture. Next, a diluted anesthetic is delivered through the fiber near the vein to be treated.

When the patient is ready, the endovenous laser ablation process begins. Laser energy is delivered to the inside of the targeted vein in restricted doses. Tissue surrounding the damaged vein that does not need to be treated is not at risk, as the procedure uses a device designed to keep the laser targeted at the damaged tissue. Eventually, exposure to the laser energy will cause the damaged vein to collapse. Pooled blood in that vein will redirect to other veins and the treated vein will dissolve into surrounding tissue. Patients should see improvements to their varicose vein symptoms within a matter of weeks.

Several clinical studies that have demonstrated the relatively high success rate and low risk of complications from endovenous laser ablation. For this reason, many vein experts today believe that endovenous laser ablation and other minimally invasive methods of varicose veins removal have largely replaced vein stripping as the primary form of treatment of underlying varicose veins.

Talk to a health specialist who treats varicose veins and spider veins listed in our medical directory for more information about endovenous laser ablation.


Reviewed by Steven E. Zimmet, MD, RVT, FACPh
Editor of Phlebology
President, Zimmet Vein & Dermatology
Past-President, American College of Phlebology

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