Laser treatment can close a malfunctioning superficial vein without traditional vein-stripping surgery. For patients with symptomatic varicose veins, endovenous laser therapy (EVLT) is one of several minimally invasive options. The best treatment depends on symptoms, vein size, ultrasound findings, medical history, and personal goals.
Visible veins do not always reveal the source of a circulation problem. A vein specialist may recommend a duplex ultrasound before treatment to identify venous reflux, confirm that deeper veins are open, and map the vein that is causing pressure in connected branches.
The MedlinePlus overview of varicose veins provides additional patient information about symptoms and treatment. Recommendations should still be individualized after an examination.
What causes varicose veins?
Leg veins contain small valves that help blood move upward toward the heart. When a valve weakens or does not close effectively, blood can move backward and pool. The increased pressure may enlarge and twist a superficial vein, creating a varicose vein.
Common symptoms include aching, heaviness, throbbing, itching, swelling, night cramps, and discomfort after long periods of standing. Some people are concerned primarily about appearance, while others develop skin discoloration, inflammation, bleeding, or sores that need medical evaluation.
How laser treatment for varicose veins works
Endovenous laser treatment uses a thin catheter and laser fiber to deliver controlled heat inside a selected vein. Ultrasound guides placement. The heat causes the vein walls to close, and blood naturally reroutes through healthier veins. The treated vein is gradually absorbed by the body.
The procedure is generally performed in an office with local anesthetic. Walking is commonly encouraged afterward, although activity, compression, and travel instructions vary. Laser treatment is not appropriate for every vein or every patient, so candidacy should be based on an examination and ultrasound rather than appearance alone.
Learn more about the practice’s endovenous laser therapy, including how EVLT differs from radiofrequency treatment.
7 treatment options for varicose veins
1. Conservative vein treatment
Regular movement, elevation, weight management when appropriate, and avoiding long periods in one position may reduce symptoms. Graduated compression stockings can help selected patients, but the correct strength and fit should be recommended by a clinician—particularly when arterial disease or another circulation problem may be present.
Conservative care does not repair a valve that has significant reflux, but it may provide relief and may be required by an insurer before a procedure. Review the clinic’s conservative vein treatment information.
2. Endovenous laser treatment (EVLT)
EVLT is a catheter-based laser treatment for a larger superficial vein with documented reflux. Ultrasound helps the physician position the fiber and monitor treatment. Because the procedure works from inside the vein, it usually avoids the larger incisions associated with older surgical techniques.
Temporary tenderness, bruising, tightness, or discoloration can occur. The treating team should explain expected recovery, compression, activity limits, and warning signs before the procedure.
3. Radiofrequency ablation (RFA)
Radiofrequency ablation also closes a refluxing vein from the inside, but it uses radiofrequency energy rather than laser energy. Both methods are forms of endovenous thermal ablation. Anatomy, prior treatment, physician recommendation, and individual preference can influence which approach is selected.
Siragusa Vein & Laser offers radiofrequency ablation for appropriate patients.
4. Sclerotherapy
Sclerotherapy involves injecting a medication that irritates and closes a selected unwanted vein. It is often used for spider veins and smaller varicose veins. Ultrasound guidance may be used when a feeding vein is not visible at the surface.
The medication, concentration, and number of sessions depend on the vein pattern. Sclerotherapy is not simply interchangeable with laser treatment; the clinician chooses the method that fits the target vein. Read about sclerotherapy.
5. Varithena foam treatment
Varithena is a prescription microfoam used to close certain superficial veins. Ultrasound may guide delivery and confirm the treatment area. It does not require the heat used by EVLT or RFA, which may make it an option for selected vein anatomy.
Possible benefits and risks should be reviewed with the physician. The number of treatment sessions and compression instructions vary.
6. Microphlebectomy
Microphlebectomy removes bulging surface branches through very small openings in the skin. The physician uses a fine instrument to remove targeted vein segments. It can be performed alone or after an underlying reflux source has been treated.
This procedure addresses visible surface branches rather than every type of venous reflux. Explore the clinic’s microphlebectomy information.
7. Ultrasound-guided sclerotherapy
Ultrasound-guided sclerotherapy allows the clinician to see and treat a vein below the surface. It may be considered for residual branches, recurrent veins, or anatomy that is not a good match for laser treatment. The ultrasound view helps confirm needle position and monitor medication delivery.
Laser treatment versus traditional vein surgery
Traditional ligation and stripping uses surgical incisions to tie off or remove a larger vein. Modern endovenous procedures often allow the same underlying reflux to be treated through a small catheter entry point. Surgery may still be appropriate in selected cases, but it is no longer the only option.
Microphlebectomy is also a surgical technique, but it is far less extensive than vein stripping. The phrase “vein surgery” can describe very different procedures, so ask the physician which vein is being treated, how access is obtained, and what recovery is expected.
Who may be a candidate for EVLT?
Laser treatment may be considered when symptoms and ultrasound findings show reflux in a vein that can be safely reached with a catheter. Symptoms may include persistent aching, heaviness, swelling, skin changes, bleeding, or a venous ulcer. Insurance coverage often depends on medical necessity and documentation of conservative care.
EVLT may not be the preferred option during pregnancy, with certain acute blood clots, when anatomy prevents safe access, or when another health condition changes the risk-benefit balance. A full medication and medical history is important. Tell the clinician about prior clots, anticoagulants, allergies, pregnancy, heart or lung disease, and previous vein procedures.
What to expect before and after treatment
Before a procedure, the office reviews the ultrasound, medications, allergies, transportation needs, and pre-treatment instructions. The physician marks or confirms the target vein and discusses alternatives. Ask whether to continue prescription medicines; do not stop a blood thinner without the prescribing clinician’s direction.
After laser treatment, walking is often encouraged, and many patients return to routine activities quickly. Strenuous exercise, lifting, heat exposure, travel, or prolonged standing restrictions vary by procedure and patient. Follow the written instructions provided by the treating team.
Contact the office for symptoms identified in the aftercare plan. Sudden chest pain, difficulty breathing, coughing blood, fainting, or severe new leg swelling requires emergency care.
Frequently asked questions
Will laser treatment make healthy veins work harder?
Closing a vein with significant reflux does not remove the body’s only route for blood return. Healthy veins continue carrying blood toward the heart. Ultrasound helps confirm that the deeper circulation is functioning before a superficial vein is treated.
Does laser treatment remove every visible vein?
Not always. EVLT treats an underlying refluxing vein, while connected surface branches may shrink gradually or require another procedure such as sclerotherapy or microphlebectomy. The treatment plan may be staged.
Are results permanent?
A successfully closed vein generally stays closed, but treatment does not eliminate genetic or lifestyle factors that can contribute to venous disease. New varicose veins can develop, and follow-up is important when symptoms return.
Is varicose vein treatment covered by insurance?
Coverage varies. Insurers may cover medically necessary treatment when symptoms, ultrasound findings, and conservative-care requirements are documented. Cosmetic treatment is often handled differently. The office can verify benefits, but the insurer makes the final coverage decision.
Schedule a varicose vein consultation in Nashville
If varicose veins cause pain, swelling, heaviness, skin changes, or concern about appearance, schedule an evaluation with Siragusa Vein & Laser. Dr. Tif Siragusa can examine the veins, determine whether ultrasound is appropriate, and explain whether laser treatment or another option best fits the findings.
Review all available vein treatment options or request a consultation in Nashville.