Endovenous laser treatment (EVLT)

If you have varicose veins in your legs, you may notice aching, heaviness, swelling, or veins that look swollen under the skin. Endovenous laser treatment (EVLT®), also called endovenous laser ablation, is a nonsurgical way to treat these problem veins. During this vein ablation procedure, heat from a thin beam of laser light is used to close the damaged vein so blood no longer flows through it. Over time, the vein shrinks and is absorbed by the body, while blood is naturally redirected through healthier veins nearby. This approach treats the source of the problem without traditional surgery and with little, if any, downtime.

EVLT is performed by vascular specialists and interventional radiologists who focus on vein health and blood flow. At Penn Medicine, our interventional radiology experts work alongside specialists in many clinical areas, including vascular medicine. We perform a high volume of image-guided procedures each year, using minimally invasive techniques to treat veins safely and precisely.

Endovenous laser treatment may be an option if your varicose veins cause pain, swelling, redness, or skin irritation, or if they affect how your legs look and feel. Many people opt for varicose vein ablation because their symptoms interfere with daily activities or don’t improve with compression stockings alone. While varicose veins are often not dangerous, treating them with an EVLT procedure can help relieve discomfort and improve leg appearance.

An EVLT procedure is usually done as an outpatient visit, meaning you can go home the same day. You’ll be given medicine to help you relax, and your leg will be numbed along the length of the vein being treated.

Using ultrasound guidance, your provider makes a very small opening in the skin and places a thin tube, called a catheter, into the vein. A laser fiber is passed through the catheter, and short bursts of laser energy heat the vein, causing it to close. The procedure takes about an hour. The small opening typically doesn’t need stitches and is covered with a bandage. After the procedure, you’ll be encouraged to walk for about 30 to 60 minutes to keep your blood moving. You’ll need a friend or family member to drive you home.

Recovery is generally quick, and most people return to normal activities within a day or two after EVLT. It’s common to have bruising, mild swelling, or soreness in the treated leg for about one to two weeks. Wearing compression stockings for several days or weeks can help reduce swelling and support healing. You may be asked to use ice packs, check the treatment site daily, and avoid soaking the leg in water for the first 48 hours. A follow-up ultrasound visit, usually within one to two weeks, lets your provider confirm that the vein has closed as planned.

At Penn Medicine, endovenous laser treatment is delivered by experienced specialists who focus on safe, effective relief from varicose vein symptoms. We offer a range of treatment options for enlarged leg veins, including endovenous laser ablation, a technique first developed by Penn Medicine specialists more than 25 years ago.