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How effective is endovenous laser treatment (EVLT)?

Endovenous Laser Treatment

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Endovenous laser treatment for varicose veins uses laser energy to eliminate certain veins below the surface of the skin that have valve dysfunction and thus are not working properly. Another name for endovenous laser treatment is endovenous laser ablation. The procedure is an alternative to surgical stripping and can be performed in an office or outpatient setting using dilute local anesthesia. It is less invasive than stripping because it can be performed through needle punctures rather than incisions. Endovenous laser treatment is most commonly done to eliminate the great saphenous, small saphenous and accessory veins. Some physicians are using it to close dysfunctional perforating veins.

The laser energy utilized during endovenous laser treatment is essentially a very concentrated beam of light. The energy can be applied to the body using a very precise and accurate machine designed to keep treatment targeted so that it does not damage surrounding tissue.

Treatment is done using local anesthetic. Sometimes a medication may also be given to relax the patient. A needle is then placed in the vein to be treated by way of a tiny needle puncture. Next, a small laser fiber and sheath are placed into the vein. Through the fiber, dilute local anesthetic is delivered around the vein to be treated. Controlled amounts of laser energy are then delivered to the inside of the vein. Laser treatment will cause the vein to close up and eventually to be reabsorbed into the surrounding tissue. Blood that used to pool in the treated vein will naturally reroute to better functioning veins. Vein blood flow overall becomes more efficient with less pooling of blood. This reduction in pooling typically causes surface varicose veins to improve. A vein doctor will track and monitor any improvements or changes to varicose vein symptoms.

Doctors often suggest combining endovenous laser treatment of underlying veins with either ambulatory phlebectomy and/or sclerotherapy to treat varicose veins near the surface of the skin.

Many studies have documented the high degree of success and the low risk of side effects from endovenous laser treatment. Thus, many medical professionals believe that endovenous laser treatment and other minimally invasive treatments have largely replaced surgical stripping as the gold standard treatment of varicose veins. Talk to a vein physician listed in our medical directory to determine if endovenous laser treatment is an appropriate treatment for your vein problems.


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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