Laser Vein Surgery – Endovenous Laser Therapy (EVLT)

What is laser vein surgery?

Laser vein surgery is a minimally invasive procedure that uses laser energy to treat varicose veins.

Varicose veins are enlarged superficial veins, most commonly found in the legs. They are twisted and larger than 3 mm in diameter, which can cause not only an aesthetic concern but also symptoms such as pain, discomfort, swelling, itching, and a feeling of heaviness in the legs.

Endovenous laser therapy (EVLT) addresses the problem of varicose veins by using a laser that delivers thermal energy to close the vein, stopping blood flow within it and redirecting it to other, healthy veins.

The main advantages of this method are:

• No or minimal pain
• Low complication rate
• Quick return to normal activities
• Long-term relief of symptoms
• Excellent aesthetic results

Who needs laser vein surgery?

The doctor may recommend the procedure in cases of varicose veins that:

• Cause symptoms such as redness, pain, and swelling of the legs
• Lead to dissatisfaction with the aesthetic appearance
• Do not respond to other symptom-relieving methods (elevation of legs, compression stockings/pneumatic devices)

As a minimally invasive procedure, EVLT is recommended for patients who want to avoid surgical removal of varicose veins, which carries a higher risk of complications and a longer recovery period.

Varicose veins are prone to progression, meaning the condition worsens over time and the risk of complications, such as venous ulcers, blood clots, and bleeding, increases. One of the purposes of the surgery is also to prevent complications.

EVLT cannot be performed in cases of smaller, reticular veins or very tortuous veins where safe catheter insertion into the vein is not possible.

How is it performed?

The procedure begins with the preparation of the area to be treated and the application of a local anesthetic. After that, a small incision is made on the skin, and a catheter is inserted into the vein to be treated, through which the laser fiber is passed. For additional analgesic effect, tumescent anesthesia is administered, consisting of a local anesthetic diluted with a saline solution.

The procedure is performed under ultrasound control, and the amount of emitted energy is monitored. As the laser fiber is withdrawn from the vein, it contracts, the walls of the vein stick together, and blood flow through the vein is stopped and redirected to other veins. The venous tissue is damaged during treatment and is spontaneously absorbed by the body within a certain period, resulting in permanent relief from symptoms.

In most cases, after the main vein is closed with laser energy, sclerotherapy with foam or miniphlebectomy follows to address the problem of smaller varicose branches of the main vein.

Finally, compressive bandages are applied to the treated areas, followed by compression stockings, which are worn for approximately the next 3 weeks.

The procedure lasts 1 – 2 hours, after which the patient is discharged from the clinic.

Preparation for laser vein surgery

Before the procedure, it is important to:

• Inform the doctor about any potential allergies and all medications you are currently taking, particularly those that affect blood clotting.
• Bring any test results as instructed by the specialist.
• On the day of the procedure, take a shower and avoid applying lotions, perfumes, or similar products to the skin.
• For 5 days before the procedure, avoid taking medications that affect blood clotting, including Andol, Aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) such as Brufen, Voltaren, Ketonal, etc.

Recovery after laser vein surgery

No hospital stay is required after the procedure, and the patient can go home.

Moderate walking is recommended. When traveling by car, it is advisable to stop every hour and walk for about 10 minutes.

Compression stockings should be worn for about three weeks after the surgery.

Bruising and swelling may occur during the first few days, so applying a cold compress for about 15 minutes to the treated area is recommended. Pain is usually not present during recovery, but if discomfort occurs, an analgesic can be taken.

The patient can return to usual activities immediately, but intense physical activity and contact sports should be avoided for two weeks after the surgery.

Risks of laser vein surgery

The use of laser for treating varicose veins reduces the risk of complications and allows for a quick and painless recovery. However, in rare cases, infection at the incision site, pain in the treated area, bleeding, nerve damage, clot formation, skin discoloration, and burns in the treated area may occur.

Price of laser vein surgery

You can check the cost of the procedure in our current price list.

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