Side Effects of Endovenous Laser Treatment

     Endovenous Laser Treatment (EVLT) is a generally a very safe procedure, but it must be performed by an experienced and well-trained specialist.  With EVLT a Phlebologist, a specialist in venous medicine, can obtain the same results as ligation and stripping 99% of the time, but without the potential harmful side effects of bleeding, infection, blood clots, and scarring that you can have with surgery.

     There are usually no major side effects associated with the body itself.  However, you may get some local nuisance side effects.  These local side effects are unpredictable for the most part, but are also generally not dangerous and usually temporary.

Laser - Since a laser is being used to essentially "fuse" the greater saphenous vein (GSV) closed there is some potential for thermal injury (burn) to the overlying skin or intervening tissue such as nerves or arteries.  Early on when the procedure was still new and experimental, there were more burns (about 5% of patients).  Now there are essentially less than 1% burns with the treatment.  Burns normally will heal without any long term problems, although if a nerve is damaged there may be some local numbness that persists.

Laser Fiber Complications - These are theoretical and unproven possibilities.  It is possible the fiber could perforation the vein.  If this happens and it is caught the procedure would be stopped and there should usually be no long term problems.  The patient would be allowed to heal and return on another day to try, again.  If the tip of the fiber should break and get lodged inside the vein, the doctor would have to make a small incision and remove the tip.

Bruising/discoloration – This is a fairly common side effect.  Like any other bruise you may have had, this will usually fade in a few days to weeks.

Hyperpigmentation - Often described as “staining”, is uncommon and it is usually caused by iron from your own blood being deposited in the skin. It almost always fades away with time.

Inflammation and trapped blood - Inflammation is a mild tenderness and/or slight swelling in treated veins that may last a few days.  Trapped blood is another common problem that occurs when a little blood gets stuck in a closed section of the treated vein.  Trapped blood feels like a firm, tender bump in the treated vein.  Trapped blood resolves by itself in a few weeks or months, but sometimes we may use a tiny needle to remove trapped blood to speed up the healing.

Neovascularization - Growth of new veins.

Blood Clots - Surgical vein treatments cause a real risk of developing blood clots. Endovenous Laser treatment may also cause a very small, (unproven) theoretical risk of getting blood clots.  We reduce this possibility by having patients wear compression hose that are designed to prevent blood clots. We also keep patients active, thereby keeping blood flowing naturally and freely in the legs.

Allergic Reaction - There is a very remote possibility of an allergic reaction to the lidocaine used as a local anesthetic.  Generally, lidocaine has an extremely low allergenicity in the general population.  Temporary allergic reactions can include hives, tingling, flushing, or a brief feeling of shortness of breath.

Recurrence of Veins - Repeat endovascular laser treatment using modified parameters may need to be done at the discretion of the doctor.