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Treatment · Medical Vein Care

EVLTEndovenous Laser Therapy

The gold-standard minimally-invasive treatment for varicose veins and venous insufficiency.

EVLT closes the failed vein at the source of your symptoms — the great saphenous vein or other refluxing trunk vein — through a single needle puncture, under ultrasound guidance, with local anesthesia. No general anesthesia. No hospital stay. Most patients walk out the same day and return to a desk job within one or two.

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Relief you can feel and see.

Most patients with varicose veins come to us with both symptoms and visible bulges — aching that gets worse by evening, swelling that leaves sock-line marks, restless legs at night, and ropy veins that have slowly developed over years. EVLT addresses both at once.

Once the diseased trunk vein is closed, the elevated pressure that drives the visible varicosities downstream resolves. Many of those bulging veins shrink on their own over the following weeks. Larger varicose tributaries that don't fully resolve can be treated separately with Varithena foam or micro-phlebectomy at a follow-up visit.

The symptoms — aching, heaviness, swelling, restless legs — typically begin to improve within days of the procedure. Skin changes (discoloration near the ankle) and chronic edema take longer, but improve as the venous pressure normalizes.

What happens at your visit.

Before the procedure

Every patient starts with a venous reflux ultrasound in our Lake Charles office. The ultrasound maps which veins have failed valves, the severity and direction of reflux, and the precise anatomy that determines whether EVLT, Varithena, or a combination is the best approach for you.

If EVLT is indicated and you have venous insufficiency symptoms documented, our team handles insurance prior authorization. Most plans require a trial of compression stockings (typically six to twelve weeks) before authorizing procedural treatment — we'll let you know exactly what your insurer needs.

The procedure itself

Performed at Imperial Calcasieu Surgery Center. You're awake the whole time — no IV sedation or general anesthesia required.

  • A small needle puncture is made over the diseased vein, typically near the knee. No incisions.
  • A thin laser fiber is threaded into the vein under ultrasound guidance.
  • Tumescent anesthesia (a numbing solution) is infused along the entire length of the vein.
  • The laser is activated and slowly withdrawn, closing the vein as it goes.
  • Total time: about 45 to 60 minutes per leg.

After the procedure

  • Compression stocking on for the first 24 hours continuously, then during waking hours for 1–2 weeks.
  • Walk for 10–15 minutes every 1–2 hours while awake — this is the single most important thing you can do.
  • Back to a desk job within 1–2 days.
  • No heavy lifting (over 25 lb), no strenuous exercise, and no air travel for 1–2 weeks.
  • Follow-up ultrasound at 1–2 weeks to confirm the vein has closed.

Full post-procedure recovery instructions are available on the Patient Info page, including a printable PDF you can take home.

Is EVLT right for me?

EVLT is the preferred treatment when a large trunk vein — typically the great saphenous vein or small saphenous vein — has documented reflux on ultrasound. It's especially well-suited to:

  • Patients with classic venous insufficiency symptoms: aching, heaviness, swelling, restless legs
  • Patients with visible varicose veins fed by an incompetent trunk vein
  • Patients who want to address the root cause of their venous disease, not just the visible surface veins
  • Patients whose anatomy on ultrasound shows a straight, accessible trunk vein suitable for laser threading

EVLT may not be the first choice for veins with very tortuous (twisty) anatomy, above-knee disease that's anatomically challenging, or branching tributaries. In those cases Varithena may be a better fit — or both may be used together.

The only way to know is a venous reflux ultrasound and a conversation with one of our surgeons. Call (337) 425-9300 to schedule.

Why Lake Area Vein Center

Vein care from a surgical group.

01

Board-certified surgeons

Drs. Devin Seale, Stephen Castleberry, and Matthew Ayo perform every procedure. Same surgeons who operate at the local hospital.

02

In-office diagnostic ultrasound

Venous reflux ultrasound by a vascular technologist in our Lake Charles office. Surgeon reviews findings at a clinic visit about a week later.

03

50 years caring for SW Louisiana

The dedicated vein program of Sulphur Surgical Clinic — locally owned, family-run, serving Calcasieu, Beauregard, Allen, and Cameron parishes.

Frequently asked

Questions patients ask about this treatment.

How does EVLT work?

Under ultrasound guidance, a thin laser fiber is inserted into the diseased vein through a small needle puncture. Numbing fluid is infused along the vein, and the laser delivers controlled heat that seals the vein closed. Blood naturally reroutes through healthy adjacent veins, and the treated vein is gradually absorbed by the body.

Does it hurt?

The numbing medication along the vein (called tumescent anesthesia) is the part most patients feel — a series of small pinches as the local anesthetic goes in. The laser portion itself isn't painful because the vein is fully numbed. Most patients describe mild soreness and bruising along the treated vein for one to two weeks afterward.

How long does the procedure take?

About 45 to 60 minutes per leg, performed in-office. You'll be in and out the same day with no overnight stay.

What's the recovery like?

You walk immediately after the procedure — walking is actually part of the treatment because it helps the closed vein stay closed and lowers your risk of a blood clot. Most patients return to a desk job in one to two days. You'll wear a compression stocking continuously for the first 24 hours, then during waking hours for one to two weeks. Strenuous exercise, heavy lifting (>25 lb), and air travel are off-limits for at least one week.

How effective is EVLT?

Long-term studies consistently show vein closure rates above 95% at one year, with sustained relief of symptoms (aching, heaviness, swelling) in the large majority of treated patients. Once a vein is closed, it doesn't reopen — though new veins can develop reflux over time, particularly if underlying risk factors (prolonged standing, family history) remain.

Will my insurance cover EVLT?

In most cases, yes. Medicare, Medicaid, and most commercial insurance plans cover EVLT when venous insufficiency is medically documented — meaning you have symptoms (pain, swelling, skin changes), reflux confirmed on ultrasound, and have completed a trial of conservative therapy (compression stockings). Our billing team verifies benefits and handles prior authorization before your procedure.

How does EVLT compare to Varithena?

EVLT is the preferred treatment for large trunk veins — the great or small saphenous vein. Varithena foam is best for tortuous, branching varicosities and above-knee disease that lasers can't easily reach. Many patients benefit from a combination, with EVLT closing the main trunk vein first and Varithena treating any residual tributaries in a second visit.

Are there any side effects?

Common, expected: bruising along the treated vein for one to two months, a firm rope-like feeling as the vein seals, mild aching for three to seven days. Less common: temporary skin discoloration that fades, small areas of nerve numbness near the ankle that usually resolves. Rare: blood clots (the reason we have you walk frequently and do a follow-up ultrasound at one to two weeks).

From the Journal

Read more from our team.

Ready to schedule?

Most patients are seen within two weeks.

An in-office vein ultrasound is the first step. Our front desk verifies your insurance and walks you through scheduling.

Lake Charles · (337) 425-9300 Sulphur · (337) 527-6363