Endovascular laser ablation is a minimally invasive procedure that can  easily and safely be performed in a physician's office.  With the patient  awake and conversant, a laser fiber is inserted through the skin and  directly into the vein that is causing the symptoms. (This feels much like  getting intravenous (IV) access, like in the hospital.) After positioning the  fiber with the use of ultrasound guidance, it is then slowly withdrawn as it  heats the inside of the poorly functioning vein causing it to shrink and be  damaged. Once the fiber is removed, there is nothing left in the leg and a  Band-Aid is placed over the access site. This technique is usually used to  treat larger veins like the greater or lesser saphenous veins and often  takes less than one hour to perform.   The procedure is performed through one access site and leaves virtually no scars. Patients  then wear compression stockings for ten days following the procedure. There is often minimal  post-procedure pain, a rapid recovery and almost immediate relief from presenting symptoms.  Bruising, hard knots or bumps and tenderness are normal. The best way to treat pain or  soreness after the procedure is with over-the-counter medicines like ibuprofen. The day of  procedure and the following day, patients can resume easy, normal activities for up to two  hours at a time with an hour of sitting and leg elevation in between each activity. Normal  walking every day is encouraged. For one week, there should be no strenuous activities such  as biking, skiing, swimming, horseback riding, extensive knee bending such as gardening,  jogging/running, or weight lifting. Hot tub use is also restricted for one week; as the heat  dilates or enlarges the veins. After one week, there are no restrictions.   As with any treatment, there are risks. The most  serious risk with laser procedure (occurs in less than  1% of procedures) is the development of a deep vein  thrombosis (DVT). We always perform an ultrasound  of the treated leg within 3-5 days after a laser  procedure as a precaution. If a patient does develop a  DVT, it often requires treatment with anticoagulants  (Coumadin) for two months afterward. Common side  effects may be mild numbness around the shin area  (lasting a few months), a pulling sensation in your  thigh (that may last few weeks) or bruising (often  mild).