Endovenous laser for varicose veins in Mexico: how it works, who it is for and what the evidence says

Reviewed by clinicaobesidadenvejecimiento.com · Last review: October 20, 2026

What varicose veins and chronic venous insufficiency are

The IMSS Clinical Practice Guideline defines chronic venous insufficiency as a condition in which blood does not return properly from the legs to the heart because of changes in the vein walls and valves, which causes reflux. Varicose veins are one of its most visible signs. In Latin America, a review in the Revista Mexicana de Angiología estimates a prevalence of about 20%.

Symptoms described by IMSS: heaviness, leg pain that worsens in the afternoon, itching, night cramps, fatigue and swelling that improves with rest. They tend to worsen when standing or in the heat and improve when lying down or raising the legs.

Risk factors: older age, family history, long periods standing, obesity, pregnancy, a sedentary lifestyle and certain occupations. The condition is more common in women.

What endovenous laser is and how it works

Varicose veins appear when the valves in the leg veins stop closing properly and blood pools. In many patients the source is the great or small saphenous vein. In endovenous laser, the doctor inserts a thin fiber into the vein under ultrasound guidance. The laser energy heats the vein wall from the inside and closes it, and blood is naturally rerouted through healthy veins. That is why it is classified as endovenous thermal ablation, the same family as radiofrequency. The ESVS 2022 guideline confirms the central role of thermal ablation in treating superficial vein insufficiency.

How it is diagnosed before treatment

The IMSS guideline recommends duplex Doppler ultrasound for accurate diagnosis in treatment candidates, and classifying the disease with the international CEAP scale, which considers clinical signs, cause, affected veins and mechanism. With that information the specialist decides whether the saphenous vein is suitable for laser, whether another technique is better, or whether conservative measures are enough. The same guideline states that these procedures should be performed in qualified units by trained surgeons.

Who is it for?

It is indicated for people with saphenous reflux confirmed by Doppler ultrasound and symptoms or skin changes; some conditions need special assessment.

In patients with a venous ulcer, the ESVS 2022 guideline recommends early ablation because it speeds healing and reduces recurrence.

Risks according to the studies

The most common risks are mild and temporary; serious ones, such as thrombosis, are uncommon.

In Mexico, a study of 158 limbs reported mild complications in about 20% and no deep vein thrombosis or embolism (Rev Mex Angiol 2023). Another Mexican study of 80 patients comparing laser and radiofrequency found no significant differences at 7 and 30 days (Rev Mex Angiol 2021).

Endovenous laser compared with other options

Guidelines rank thermal ablation, such as endovenous laser, as the first choice; foam, surgery and stockings are kept for other cases.

1. Thermal ablation (laser or radiofrequency): first choice if the patient is a candidate (NICE CG168, ESVS 2022).
2. Ultrasound-guided foam sclerotherapy: an alternative when ablation is not suitable.
3. Traditional surgery (stripping): when the above are not suitable.
4. Compression stockings: only when no treatment is possible.

Earlier versions of the Cochrane review concluded that laser, radiofrequency and foam are at least as effective as surgery, and in the CLASS trial recovery with laser was faster.

Recovery step by step

Patients walk the same day and most return to their activities within a few days.

1. Same day: the patient walks out; bandage or compression stocking as indicated.
2. First days: mild discomfort and bruising; walking is encouraged and long sitting avoided.
3. First weeks: control ultrasound to confirm closure and rule out thrombosis.
4. Following weeks: visible varicose veins shrink; some branches may need complementary treatment.

Seek immediate care for severe pain or sudden leg swelling, shortness of breath or chest pain.

How to care for your veins before and after

The IMSS guideline recommends regular physical activity (especially walking and swimming), calf exercises when sitting for more than 5 hours, avoiding constipation and consulting a doctor before starting hormone therapy. These measures do not replace treatment of the diseased vein, but they help control symptoms and protect the result.

Myth and fact

Frequently asked questions

Keep reading

Sources

1. Instituto Mexicano del Seguro Social. Clinical Practice Guideline: Chronic Venous Insufficiency (IMSS-175-09). IMSS
2. Kettenhofen-Jiménez SE, et al. Endovenous laser ablation: short-term complications. Rev Mex Angiol. 2023;51(3). SciELO Mexico
3. Lozano-Balderas G, et al. Radiofrequency vs. 1470 nm laser ablation for chronic venous disease. Rev Mex Angiol. 2021;49(4). SciELO Mexico
4. Revista Mexicana de Angiología. Chronic venous disease, 2018. Medigraphic
5. De Maeseneer MG, et al. ESVS 2022 Clinical Practice Guidelines on Chronic Venous Disease. Eur J Vasc Endovasc Surg. 2022;63(2):184-267. Summary
6. National Institute for Health and Care Excellence. Varicose veins: diagnosis and management (CG168). NICE
7. Brittenden J, et al. A randomized trial comparing treatments for varicose veins (CLASS). N Engl J Med. 2014;371:1218-27. NIHR summary
8. Whing J, et al. Interventions for great saphenous vein incompetence. Cochrane Database Syst Rev. 2021. Cochrane
9. Healy DA, et al. Thrombotic events following endovenous thermal ablation: systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2018. PubMed
10. Endovenous laser ablation using laser systems over 1900 nm: a systematic review. 2022. PubMed
11. Endovenous laser ablation-induced complications: review of the literature. Dermatol Surg. 2009. PubMed