EVLT does not require any particular preparation and neither hospitalisation or the use of an operating room (several studies, including a French case study of 1700 cases, show the innocuousness of this technique performed outside the operating room).
An empty stomach is not necessary and premedication is not generally required, but anxious people may be prescribed an anxiolytic.
Patients do not need to stop taking any ongoing medication, particularly anticoagulant or anti platelet medication.

This treatment is an treatment and it takes from half an hour to 2 hours.

A preoperative examination with a is used to determine the exact location of the varicose veins to be treated.
The optical fibre is inserted into the varicose vein under a strict local anaesthetic by The activation of the laser firing delivers heat that progressively destroys the vein as the fibre is withdrawn. The entire procedure is performed with Duplex scan guidance.

It is possible to treat several on one or two lower limbs during one session, the limit being determined by the total length of time that a patient can remain under local anaesthesia (2 hours maximum).

Then, once the fibre is in place, a tumescent liquid (which is most often refrigerated) is injected around the varicose vein. This tumescence acts as a liquid insulator around the varicose vein in order to protect surrounding tissues from burning. It also compresses the varicose vein against the fibre in order to reduce its volume and therefore the intensity necessary to destroy the varicose vein.

The complete procedure is performed under constant Duplex scanning: the preoperative examination to determine the area to be treated and feasibility of the operation, the immediate preoperative the introduction of the catheter, the advancement of the fibre as well as the ideal positioning of the tip of the fibre to the nearest millimetre next to the deep vein into which the varicose vein flows, the slightest adjustments of the tumescent refrigerated liquid (the patient does not feel any cold sensation), and lastly the withdrawal of the optical fibre while the laser is being activated.
All this implies that practitioner and ultrasonographer must be one and the same person: the contrary would amount to dissociating the hands from the eyes and brain.

EVLT requires no associated general or epidural anaesthesia and they should be regarded as dangerous in this type of treatment. Indeed, only the use of strict tumescence allows for the absolute vigilance of the patient while laser is being operated in order to avoid any risk of burning tissues around the varicose vein being treated.
All the materials used are sterile and disposable, including the laser fibre.
During the whole procedure, the patient wears glasses to protect his/her eyes against possible accidental exposure to the laser beam.

At the end of the operation, compression is applied for 15 days, most often with the use of contention tights or stockings, to avoid postoperative inflammation and the risk of occurring.

Analgesic and anti-inflammatory drugs are prescribed as postoperative medication. Currently (2010), the recommends a preventive injection of over 3 to 4 days.

According to the most significant case studies, time off work lasts from 0 to 15 days, with a median of 3 days.

The patient will also be strongly advised to take an active walk for at least an hour a day in order to reduce the risk of phlebitis occurring and to limit postoperative pain.

An annual check-up with a Duplex scan is essential to follow the evolution of this progressive and chronic disease (which is probably genetic). The possible need for complementary treatment by sclerotherapy, foam sclerotherapy, and, if need be, Muller's phlebectomy will be determined during these examinations.

In fact, following EVLT treatment, like after stripping surgery, it is often necessary to treat collateral and of a smaller diameter. The number of postoperative sessions depends on the number and diameter of these collateral varicose veins.
In some cases these sessions can be scheduled at short intervals over a few days.