Varicose Vein Treatment (Endovenous Ablation)

What are Varicose Veins?

Varicose veins are abnormally large veins commonly seen in the legs. Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves which allow blood to return from the legs against gravity. If the valves leak, blood pools in the veins, and they can become enlarged or varicose.

 

How are Varicose Veins treated?

Varicose vein treatment, also known as endovenous ablation, uses radiofrequency or laser energy to cauterize and close varicose veins in the legs. It may be used for cosmetic purposes, but it is most commonly used to help ease varicose vein related symptoms such as aching, swelling, skin irritation, discoloration or inflammation. Endovenous ablation is safe, less invasive than conventional surgery, and leaves virtually no scars.

 

Who interprets the results and how do I get them?

A follow up ultrasound examination is essential in order to assess the treated vein and to check for adverse outcomes. Within one week, the target vein should be successfully closed. Additional procedures (such as sclerotherapy or phlebectomy) may be necessary to treat associated veins.

Varicose Veins Before & After

What will I experience during the procedure?

 

  • You will be asked to wear protective glasses if and when lasers are in use.
  • An area of your leg will be cleaned and numbed.
  • You will feel a slight pin prick when the local anesthetic is injected at the vein access site and during injection of the local anesthetic along the length of the vein.
  • This area will become numb within a short time.
  • You may feel slight pressure when the catheter is inserted, but no serious discomfort.
  • Injection of local anesthetic around the abnormal vein is the most bothersome part of the procedure because it usually requires multiple injections along the vein. Actual closure of the vein with laser or radiofrequency is usually not painful. Occasionally, some people report a smell or taste of something burning during the vein closure.
  • Following the procedure, you will need to wear a gradient compression stocking to help reduce bruising, tenderness, and minimize the rare possibility that blood clots may form.
  • You may resume your normal activity immediately, with the exception of air travel or prolonged sitting (such as a long car trip). You should remain active and not spend too much time in bed during the recovery period since this increases the chance of complications. However, strenuous physical activity should usually be avoided for some period of time following the procedure.

Benefits

  • No surgical incision is needed—only a small nick in the skin that does not have to be stitched.
  • When compared with traditional vein stripping techniques, endovenous ablation is more effective, has fewer complications, and is associated with much less pain during recovery.
  • Endovenous ablation is generally complication-free and safe.
  • This procedure leaves virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions.
  • Endovenous ablation offers a less invasive alternative to standard surgery.
  • Most of the veins treated are effectively invisible even to ultrasound 12 months after the procedure.
  • Most patients report symptom relief and are able to return to normal daily activities immediately, with little or no pain.

Risks

  • Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
  • Any procedure that involves placement of a catheter inside a blood vessel carries certain risks. These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. However precaution is taken to mitigate these risks.
  • Some post-procedure bruising and tenderness may occur, but may be eased by wearing a compression stocking.
  • Some instances of thermal (heat) damage to nerves have been reported. This is rare and generally goes away in a short time.
  • Thrombophlebitis (inflammation of the vein) is not uncommon and may cause pain and redness over the treated area, but generally responds well to nonsteroidial anti-inflammatory drugs (NSAIDs) as well as ice over the area.
  • Blood clots that formed in the veins can travel to the lungs (pulmonary embolism); however, this is an extremely rare occurrence.

Source: radiologyinfo.org