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Frequently Asked Questions about Endovenous Laser Ablation (ELA)

How is the treatment performed?

ELA is done in our office under local anesthesia. The doctor inserts a small laser fiber, usually through a needle stick in the skin, into the damaged vein around the knee level. With the help of an ultrasound, the doctor guides the fiber to the upper thigh. Pulses of laser light are delivered as the fiber is pulled through the vein, causing it to collapse and seal shut.

How do I prepare for ELA?

You can eat and take medication on the morning of your procedure. We can provide a mild anti-anxiety medication if you need it. You should wear loose-fitting pants or sweats because your legs will be wrapped with elastic bandages after the procedure.

How long will the treatment take and how many are needed?

Please arrive 15 minutes early to check in and prepare for the procedure. The treatment itself takes 30-60 minutes per leg. Typically, only one laser procedure per leg is necessary.

What can I expect after ELA?

Your leg will be wrapped in bandages. But, because the procedure is performed through a tiny skin nick, you won’t have a scar. It’s possible you’ll need also sclerotherapy to completely eradicate all varicose veins.

What are the possible side effects?

  • Temporary numbness
  • Deep vein thrombosis
  • Recurrence of the varicose vein
  • Bruising and leg cramping
  • Pain is most often considered minimal

How much does ELA cost and does insurance cover it?

Most insurance policies won’t cover elective cosmetic surgery for varicose veins. However, in many cases, if your varicose veins are causing pain, swelling or other symptoms, most insurance companies will cover the treatment. Check with your health insurance plan for complete details. We bill your health plan as a courtesy, but you are responsible for any balance.

Does it work?

Results have been favorable with success rates equal to the more painful and invasive approach of surgical ligation and stripping. ELA will normally treat most varicose veins, but additional therapy, such as sclerotherapy, may be necessary.

What other options do I have?

  • You can choose to forego treatment. The varicose and spider veins may progress and new ones may form. You should have periodic reevaluations.
  • Your doctor might suggest support hose to promote circulation.
  • Or, if you have larger varicose veins, surgical stripping could be appropriate. Please talk with your physician to discuss your options.

Will the laser damage my skin?

No. Vascular lasers target the pigment in blood, so blood vessels are destroyed without affecting surrounding skin.

What happens before and during the procedure?

Before the procedure, you’re given a mild sedative and local anesthesia to numb the area. You’ll wear special eye goggles to protect against accidental exposure to laser light. During the procedure, a small laser fiber is inserted into the damaged vein and positioned with ultrasound guidance.

Is there scarring or bruising? Does it hurt?

There is minimal risk of scarring because this laser treatment requires just a tiny puncture. Most patients will bruise in their thigh, but this resolves itself in a few weeks. We use a local anesthetic during the procedure, so you don’t feel pain while the laser is working. Patients report only mild discomfort associated with this procedure.

Where is ELA performed?

The procedure is performed our office. Typically only one laser treatment is required per leg. Laser therapy is often combined with sclerotherapy to fully treat varicose and spider veins.

What happens after ELA treatment?

  • For the first 48 hours, avoid aerobics, jogging or long periods of sitting and standing.
  • Wear compression hose for two weeks.
  • Your skin will appear discolored and bruised for up to six weeks.
  • You may experience mild discomfort in the inner thigh. You can take Advil or ibuprofen.

What are the benefits of vein laser treatment?

  • The treatment takes less than an hour and provides quick relief of symptoms.
  • You can return to normal activity sooner than with surgery.
  • There is no scar, because the procedure doesn’t require a surgical incision.