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Varicose Veins Laser Treatment, EVLT

At Nu Vela Laser and Vein Center, we are pleased to offer varicose vein laser treatment with Sciton’s Endovenous Laser Therapy system, EVLT , one of the best treatments, besides Venefit, for endovenous ablation (or closure) of incompetent saphenous /perforator veins, the root cause of most varicose veins.

The closure of problematic saphenous/perforator veins (not visible to the naked eye) is of crucial importance for the achievement of lasting relief from symptoms associated with chronic venous insufficiency or varicose veins, and for creating conditions where it becomes possible to achieve predictable and long term improvement in the appearance of branch varicosities and other smaller unsightly veins.

The Sciton Pro-V laser used at Nu Vela Laser and Vein Center is a newer generation, FDA approved laser that uses an optimal wavelength of 1319 nm. This wavelength is ideal for vein ablation because unlike some of the older laser systems used for EVLT, it targets the vein wall itself, and not the blood content of the vein. The result is a fast and comfortable varicose vein ablation with a smooth recovery experience.

Note that since the introduction of the Endovenous Laser ablation technique in the early 2000s, over one million procedures have been performed worldwide. In published clinical studies, the success rate of varicose vein treatment using Endovenous Laser Treatment ranges from 93-95 percent for the saphenous veins, with minimal side-effects or complications. In our experience with the more current Endovenous Laser Treatment system, this success rate runs at higher than 95 percent, an outcome as good or better than surgical ligation and stripping.

Thermal Vein Ablation and EVLT

Until a decade ago, vein ligation/stripping surgery was the only option for treating bulging leg varicose veins. This surgical treatment for varicose veins involved the physical removal of the targeted vein, requiring hospitalization, general anesthesia, and resulted in scarring and significant post-surgical pain and discomfort. Unlike traditional ligation/stripping surgery, Endovenous Laser Treatment for varicose veins (commonly Known as EVLT, ELT, EVLA) does not involve the physical removal of a vein; but relies on Ultrasound image-guided thermal ablation (damaging and sealing with heat application) of the diseased varicose vein from within the vein by means of a laser fiber introduced through a slightly enlarged needle hole, near the targeted vein.

Note that surface lasers intended for the laser removal of small superficial veins, such as spider veins, are not effective in treating the larger varicose veins and would risk causing significant thermal damage to surrounding tissue if used on these veins. If interested in the application of surface lasers in vein treatment, click laser spider vein treatment or laser removal of facial veins.

The Veins that are Targeted with the EVLT Laser

Varicose Veins develop mainly when blood from deep veins flows in a reverse-flow-pattern into the superficial main veins of the leg; namely, the saphenous veins and the connecting perforator veins. The resultant downward flow of blood with gravity, instead of the upward movement toward the heart, results in a condition known as venous reflux or venous insufficiency. If not treated, the latter may cause restless legs at night, leg cramps, heaviness and pain in the legs, and may progress into a number of more serious complications, such as hardening and pigmentation of the tissues above the ankle, bleeding, leg swelling (edema), venous congestion ulcers (venous stasis ulcers), and superficial venous thrombosis.


Advanced Chronic Venous Hypertension Treated with EVLT
*Individual results may vary.

Endovenous Laser Treatment targets incompetent saphenous and perforator veins for correcting the blood flow pattern and treating venous reflux. Once these incompetent veins are thermally ablated, the blood ceases to flow in them, and the blood flow in the deep veins reverts to its normal pattern towards the heart. Within a few weeks following the treatment, the enlarged and bulging superficial leg veins adjust back to normal pressure conditions and show dramatic visible improvement in their appearance. A few weeks following Endovenous Laser Treatment, further cosmetic improvement can be achieved by treating the residual veins with microphlebectomy, foam sclerotherapy, or sclerotherapy, three common non-surgical procedures for foot and leg vein treatment.

Note that occasionally varicose veins may appear without any underlying venous reflux from the deep veins, although in most cases venous reflux is present, and as such, has to be actively sought out and diagnosed with Venous Duplex Ultrasound before proceeding forward with treatment regimens targeting the visible surface veins.

Endovenous Laser Treatment – The Procedure

At Nu Vela, Dr. Raffi Dishakjian, the vein specialist of the vein clinic, will first take a full set of baseline pictures of the legs and then perform a Duplex Venous Ultrasound imaging to mark the anatomic location of the problematic vein on the overlying skin. Additional points noted by the doctor would include the caliber of the vein, any significant side branches, curved or twisted segments in the vein, and the most suitable needle entry point into the vein—most commonly located just above or below the knee area, depending on which vein is targeted.

When treatment starts, Dr. Dishakjian will insert a tube (catheter) in the vein and pass a laser fiber through it, using Ultrasound guidance. After carefully pushing the fiber inside the vein towards the targeted section of the vein, the doctor will inject an abundant quantity of a dilute numbing solution around the vein, which, besides its numbing action, acts as an insulating sleeve and protects the surrounding tissues from heat damage. As the doctor applies short bursts of laser energy and withdraws the fiber, the heat applied to the vein wall will destroy its regenerative capacity and the vein will shrink and eventually close. The session will end after wrapping the leg with bandages and applying compression stockings.

Although patients are awake during the procedure and are able to walk immediately, they are advised not to drive back home as the treated leg may be partially numb. Most patients resume their normal activities even on the next day, as pain is bearable and easily manageable with over-the-counter medications, such as Advil.


Before and after EVLT for varicose vein treatment
*Individual results may vary.

Preparing Yourself, Recovery, Complications, and After Care

Instructions for preparing yourself for Endovenous Laser Treatment of varicose veins and aftercare are essentially the same as those recommended for Venefit™ Targeted Endovenous Therapy. Please click EVLT & Venefit FAQ for answers to questions you may have about these procedures, or go to varicose veins- FAQ to find answers related to varicose veins and their treatment.

Questions about the Cost of EVLT or the Procedure?

Call 818-832-4500 for any queries regarding the cost of Endovenous Laser Treatment for varicose veins, insurance coverage, additional information, or scheduling a consultation session with Dr. Dishakjian, the phlebologist of the vein clinic. Endovenous Laser Treatment is covered by most PPO insurance plans and Medicare when the treatment is medically necessary. Consultations with the doctor are free with the purchase of any service. We charge a nominal fee for the first office visit only. This fee is fully credited towards the cost of a subsequently purchased service. Note that Consultation does not include the charge for a venous Duplex Ultrasound test when indicated. However, most of the fee for the ultrasound test is reimbursed to you with a follow-up endovenous treatment procedure.

Click vein treatment in Los Angeles to read about other treatments available at the Center.