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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.

What are Varicose Veins?

Varicose veins occur when blood flow in your legs reverses direction, causing veins to bulge and twist. This can lead to symptoms like leg pain, heaviness, and fatigue. In some cases, if left untreated, varicose veins can develop into more serious complications.

Importance of Closing Saphenous or Perforator Veins

Closing problematic saphenous or perforator veins, which are not visible to the naked eye, is crucial for lasting relief from symptoms associated with chronic venous insufficiency or varicose veins. This closure also enhances the condition, enabling long-term improvement in the appearance of branch varicosities and other smaller, unsightly veins.

Sciton Pro-V Laser for Endovenous Laser Therapy

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


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 often led to scarring, along with 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 using 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.


Varicose Veins develop mainly when blood from deep veins flows in a reverse 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 several 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.


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 can 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.


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.


Can EVLT Be Used to Treat Both Superficial and Deep Varicose Veins, and How Is the Treatment Plan Customized for Each Patient?

Endovenous Laser Treatment (EVLT) is a flexible option for treating varicose veins at any depth. By distinguishing between superficial and deep veins, Dr. Raffi Dishakjian will create tailored plans for each patient. Before EVLT, an ultrasound maps the veins, ensuring a customized approach that maximizes the treatment’s effectiveness.

What is the durability of EVLT results, and what factors affect it?

EVLT offers long-lasting relief from varicose veins, with results that can endure for years. Lifestyle choices, genetic factors, and following post-treatment recommendations all play roles in maintaining these results. Activities like regular exercise, maintaining a healthy weight, and using compression stockings help prolong EVLT’s benefits.

Can EVLT Be Performed on All Skin Types and Vein Colors, and Are There Any Contraindications to Be Aware of?

EVLT works well for all skin types and vein colors. However, it’s not suitable for everyone. Conditions like deep vein thrombosis, pregnancy, and severe peripheral arterial disease may require different treatments.

How much does EVLT cost, and is it covered by insurance?

The cost of EVLT can vary based on the extent of treatment needed. While insurance coverage for EVLT often depends on the plan and the necessity of the procedure, many providers recognize it as a medically necessary treatment. Patients are advised to discuss financial considerations with their provider and insurance company.

Can EVLT be repeated for recurring varicose veins? What should be considered?

If varicose veins return, EVLT can be redone. Doctors will evaluate the cause of the recurrence and may adjust the treatment strategy to achieve the best long-term outcome.


For any queries regarding the cost of EVLT for varicose veins, insurance coverage, additional information, or scheduling a consultation session with Dr. Dishakjian, the phlebologist of the vein clinic, call 818-832-4500. 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.


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