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The EVLT Procedure


EVLT is a quick, minimally invasive laser procedure that can be performed in the doctor’s office. There is no post-operative scarring, as it is only a probe and a slim sheath that enters the vein via a needle. The probe is guided into place using ultrasound and the procedure is performed under local anesthetic – to numb the treatment area. The treatment takes one to two hours.

The probe is guided into place using ultrasound and the procedure is performed under local anesthetic – to numb the treatment area. The treatment takes one to two hours.

Here’s what to expect:

  1. Your doctor uses ultrasound to map out your vein.
  2. Local anesthetic is applied.
  3. A thin laser fiber is inserted through a small needle.
  4. Laser energy is delivered to seal the faulty vein.
  5. Your normal day activity is then resumed. In fact, walking immediately after the procedure is required (just avoid rigorous activities).

The key benefits of EVLT

  • Relief from symptoms
  • Minimal scarring
  • Only a local anesthetic is needed
  • Can be performed in the doctor’s office (no hospitalization needed)
  • Treatment in one to two hours
  • Normal activities can be resumed immediately – with mild pain and bruising

EVLT Treatment - Pre Operative

EVLT Treatment – Pre Operative

EVLT Treatment - Post Operative

EVLT Treatment – Post Operative


Preparing for your EVLT procedure (EndoVenous Laser Treatment)

You will be given a prescription (or one will be called in for you) for Xanax. It is an anti-anxiety medication that can help you relax, but more importantly, it is to help your veins relax. This will help avoid complications during your procedure. Bring the medication to the appointment but do not take until instructed by office staff.

Since we cannot allow you to drive after taking this medication, a friend or family member needs to come with to drive you home after the procedure. This will also allow you to put your foot up for the drive home.

If you want, you can take ibuprofen (Motrin, Advil) or tylenol prior to the procedure to pre-treat for pain and inflammation. It is also okay to take some once you get home.

Please eat normally the day of your procedure. This means to not overeat or skip any meals prior to your procedure.

You will be getting a thigh-high compression stocking at the time of your first EVLT appointment. It is not bulky and shoes should fit without difficulty. This stocking will be used after all future treatments. There will be a charge for this stocking (approximately $23.00) Please be prepared that insurance does not cover the cost of this stocking.

There is an extra chair in the procedure room for one guest to accompany you during the procedure. It is your choice to have someone come in with you. Please feel free to bring a MP3 player, iPod or music and headset of your choice to listen to during the procedure. Some patients have found this to be relaxing.

Take a shower or bath the morning or night before your procedure and thoroughly wash your leg. Please do not apply any lotions to your leg day of procedure. • We ask that you be sure you are on time for your appointment. Time has been built in to your appointment to review all paperwork and answer all questions.

If you need to reschedule your 2 hour EVLT procedure, please do so 3 DAYS in advance. It is very difficult if not impossible to find someone else to fill that appointment on short notice. Canceling on short notice is very costly and inconvenient for our staff and Dr. Hertzman.

Please review these forms prior to your phone conversation with the nurse and again prior to your procedure. You do not need to bring them to your EVLT procedure. If you have any questions or concerns prior to your appointment, please do not hesitate to call our office at 662-2900 and speak to one of the nurses.

Post-EVLT Instructions

Keep the stocking on for 72 hours, remove it yourself at the end of that time. Bring stocking to all future treatment appts. After removing stocking, wear your below the knee stockings as much as possible until your follow up appointment. To shower, cover leg with a bag. If stocking starts to become painful, pull it down or take it off for a time and then replace it. It is okay to wash this stocking in the laundry.

You will have a piece of tape over your access site. It will start to come off about 7 days after your procedure. No need to cover it when showering, but otherwise keep it clean and dry.

Recovery from EVLT is usually trouble-free. It is normal to see significant bruising, to have swelling, and to have some pain and/or soreness that may be worst on days 2 and 7 post-procedure.

Pain can generally be managed with over-the-counter analgesics. Dr. Hertzman recommends patients take 400-600mg of ibuprofen (advil/motrin) 3 times a day for 3 days with food. If you are not able to take ibuprofen, but can take aleve (naproxen), take 2 tablets, twice a day. If you are unable to take ibuprofen or aleve, please take 2 tablets Extra Strength Tylenol 3-4 times a day. This will greatly decrease the discomfort and inflammation (swelling, redness) from the procedure. Please call our office if you are having pain that the above medications is not helping enough with.

We are requesting all patients not on Coumadin to take one “baby” aspirin (81mg) daily for the next 7 days. This will hopefully help reduce post-procedure complications.

You will be expected to walk for at least 30 minutes immediately after the procedure and a minimum of 30-60 minutes everyday thereafter. This is important to help avoid blood clots.

Avoid prolonged sitting or standing and whenever possible keep your legs elevated – avoid dangling!! Even with your hips is ideal, anything is better than nothing. Elevation while in bed is unnecessary. This will also help you to avoid blood clots.

Normal activity can be resumed immediately, but strenuous exercise can cause the vein to reopen or prolong recovery, so please avoid heavy lifting, squatting and vigorous activity such as gym workouts (including lunging, excessive jumping, kicking, or heavy weights – upper body as well as lower body) for at least 7 days following the procedure.

Avoid hot baths, especially hot tubs/jacuzzi’s, for 7 days.

Air travel and prolonged auto travel (Santa Fe and ABQ are okay) are forbidden for 7 days post procedure for all treatments.

You need to call the office the day after your procedure to check in with the nurse.

As with any invasive procedures, problems can develop. If you develop an acute fever (more than 100 F or 38 C) or severe or worsening pain/swelling, have discomfort or feel numbness in your foot or toes please contact our office immediately. 662-2900