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Endovenous Laser Varicose Vein Surgery

What is endovenous laser varicose vein surgery?

Endovenous laser varicose vein surgery is a procedure that uses heat from a laser to reduce varicose veins. Varicose veins are swollen, bulging veins that often happen on the thighs or calves. A laser is a device that sends a thin beam of radiation in the form of light.

Laser surgery closes and shrinks the varicose vein and causes scar tissue within the vessel. This seals off the vein. Blood then flows through other nearby veins instead.

Why might I need endovenous laser varicose vein surgery?

Your healthcare provider may suggest laser surgery if your varicose veins are sore, or red and swollen (inflamed). Laser surgery may also be advised if the skin over your varicose veins is irritated.

Varicose veins are not usually a serious health problem, but they can be painful. You may also not like how they look.

What are the risks of endovenous laser varicose vein surgery?

All surgeries have some risks. Some risks of laser varicose vein surgery include:

  • Infection

  • Pain over the vein

  • Bleeding

  • Bruising

  • Nerve damage

  • Redness or swelling (inflammation) of the vein

  • Blood clots

  • Changes in skin color over the treated vein

  • Burns

You may have other risks, depending on your general health. Be sure to talk with your healthcare provider about any concerns you have before your surgery.

How do I get ready for endovenous laser varicose vein surgery?

  • Your healthcare provider will explain the procedure to you. Ask any questions you have about the procedure.

  • You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

  • Your healthcare provider will ask questions about your health history. They may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests.

  • Tell your healthcare provider if you have a history of bleeding disorders. Let your healthcare provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.

  • Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, tape, contrast dyes, and anesthesia medicines (local and general).

  • Tell your healthcare provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.

  • Follow any directions you are given for not eating or drinking before surgery.

  • You may have medicine to help you relax (sedative).

  • Arrange to have someone to drive you home after the procedure.

 Your healthcare provider may have other instructions for you.

What happens during endovenous laser varicose vein surgery?

This procedure usually doesn’t require a hospital stay. It may be done in your healthcare provider’s office or outpatient treatment center. The procedure usually takes less than an hour. You can likely go home the same day. Bring loose-fitting clothing to wear right after your surgery.

Generally, endovenous laser varicose vein surgery follows this process:

  • You’ll change into a hospital gown and lie down on an exam table. The table may be tilted in different positions during the procedure. You may be given special goggles or eyeglasses to wear during the surgery. This is to protect your eyes from the laser light.

  • Your healthcare provider will numb the area where the tube or catheter will be put into your vein. Your healthcare provider will also give you a shot or injection of numbing medicine along the length of the vein that will be treated.

  • Your healthcare provider will use a Doppler ultrasound device to check the vein before and during the procedure. This process uses sound waves to make an image of the vein on a computer screen.

  • Your healthcare provider will make a small cut or incision in your skin and insert the catheter. It will be guided into the varicose vein. A laser fiber will be put into the catheter. As your healthcare provider slowly pulls out the catheter, the laser will heat up the length of the vein. The vein will close up and should eventually shrink.

The procedure usually takes less than an hour. The cut where the catheter was inserted will likely be small enough that you won’t need stitches. A bandage will be put on the site.

What happens after endovenous laser varicose vein surgery?

You will be encouraged to walk right after the procedure, for about 30 to 60 minutes.

Your leg may have some bruising. The bruises should go away in about 2 weeks.

You will need to have someone drive you home after your surgery.

At home

After you go home, be sure to follow any instructions from your provider. You may be told to:

  • Put an ice pack over the area for 15 minutes at a time, to help reduce swelling.

  • Check the incision sites every day. It’s normal to see light pink fluid on the bandage.

  • Keep the incision sites out of water for 48 hours. You may need to take a sponge bath until the bandages are removed.

  • Wear compression stockings for a few days or weeks, if advised. These stockings gently squeeze your legs. This helps to prevent swelling in your legs. It can also help stop your blood from clotting or pooling.

  • Not sit or lie down for long periods of time. Keep your leg raised when sitting.

  • Not stand for long periods of time.

  • Walk about 3 times a day for 10 to 20 minutes each time. Do this for 1 to 2 weeks.

  • Keep active, but don’t run, jump, or lift heavy things for 1 to 2 weeks.

  • Not take hot baths for 1 to 2 weeks.

When it comes to medicine, be sure to:

  • Take over-the-counter pain medicine as needed, and only if advised by your healthcare provider. Some medicines can increase bleeding.

  • Ask your healthcare provider when it will be safe to take blood-thinning medicine again, if you stopped taking it for the surgery

Your healthcare provider may want to give you an exam at a follow-up visit. They may use ultrasound to make sure the laser procedure worked.

Call your healthcare provider if you have:

  • Signs of infection in the treated area. These include redness, warmth, or fluid leaking from the incision. 

  • Swelling that gets worse, or new swelling

  • Any pain that keeps you from doing your normal activities

Your healthcare provider may give you other instructions.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure

  • The reason you are having the test or procedure

  • What results to expect and what they mean

  • The risks and benefits of the test or procedure

  • What the possible side effects or complications are

  • When and where you are to have the test or procedure

  • Who will do the test or procedure and what that person’s qualifications are

  • What would happen if you did not have the test or procedure

  • Any alternative tests or procedures to think about

  • When and how you will get the results

  • Who to call after the test or procedure if you have questions or problems

  • How much you will have to pay for the test or procedure

Medical Reviewers:

  • Anne Fetterman RN BSN
  • Callie Tayrien RN MSN
  • L Renee Watson MSN RN
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