THE WOMEN'S CENTER
Venous Ablation
About
What are varicose veins?
Veins carry blood from our legs upward, against gravity, back to the heart. These veins have one-way valves to prevent the blood from flowing backwards, down the legs. These valves may fail to close tightly, allowing blood to flow backwards and pool in the legs. This causes the bulging and twisting characteristic of varicose veins.
Causes of varicose veins include:
- Inherited
- Previous pregnancy
- Increasing age
- Obesity
What problems are casued by varicose veins?
The unpleasant appearance of varicose veins is often bothersome, but many people have symptoms related to their varicose veins. Also, severe medical complications can arise if varicose veins are left untreated.
Common Symptoms
- Aching or cramping
- Heaviness or swelling
- Skin discoloration
If Left Untreated, Possible Complications of Varicose Veins
- Skin ulceration
- Bleeding
- Blood clots
Will insurance cover the procedure?
Many insurance companies will cover the expense of this exciting new option. After an initial ultrasound and consultation, we will contact your insurance provider to determine eligibility.
For patients suffering from varicose veins, new techniques that treat the veins from the inside, called endovenous radiofrequency ablation (RFA) and laser ablation offer less invasive alternatives to standard surgery. Ablation procedures use heat energy from either radio waves or a laser source to seal the afflicted vein. Local anesthesia is all that is required, and patients often feel immediate relief. Interventional radiologists perform these procedures on an outpatient basis and when compared with traditional "vein stripping" techniques, endovenous ablation is more effective, has fewer negative outcomes, and is associated with much less pain during recovery. There are virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions.
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What To Expect
The leg being treated will be sterilized and covered with a surgical drape. A local anesthetic (usually xylocaine) will be administered to the site where the incision will be made, generally immediately above or below the knee. Let your doctor know if you have an allergy to anesthetics.
By the time the heat energy is delivered, the vein should be numb and there should be no pain. The procedure starts by advancing the catheter inside the vein up to the top of the leg and then the energy is deposited as the catheter is slowly withdrawn. Throughout the procedure, the radiologist guides the catheter using the external ultrasound wand positioned directly outside on the surface of the leg. Endovenous ablation typically takes one hour.
A compression stocking must be worn after the procedure to help reduce bruising, tenderness, and the slim possibility of forming blood clots. Normal activity can be immediately resumed, with the exception of lifting heavy objects or prolonged sitting (for instance a long plane or bus trip). You should not remain inactive or spend too much time in bed during the recovery period since this increases the chance for clotting complications.
Endovenous ablation is successful at closing the main vein almost 100 percent of the time, but small dilated branches that persist in the skin often require additional treatment with phlebectomy (a minor surgical procedure to extract them) or injection of a liquid agent to seal them off, called sclerotherapy. Subsequent treatments can be scheduled two to four weeks after ablation.
Is Laser Vein Ablation painful?
Most patients agree that the procedure is not painful. Patients are up and walking as soon as it’s over, able to return to full normal activity…thus with no “recovery period” needed. Slight swelling may occur right after the procedure, but immediate results will be evident.
How soon will results be evident, and will they last?
The procedure has an outstanding 97% record of success, with no reoccurrence in the veins that were treated. In some cases, follow-up procedures may be desired to obtain optimal aesthetic results.
Patient Preparation
No special preparation is necessary. However, you may be asked to wear protective glasses while lasers are in use. Patients who take blood thinners on a daily basis may be asked to stop their medication in advance of the procedure to minimize the risk of bruising and bleeding.
Common Uses for the Test
Endovenous ablation offers a safe, effective and easy method of eliminating varicose veins, which can cause debilitating leg symptoms such as severe pain and skin ulceration. Normally, the veins in the leg return blood to the heart by the pumping action of the muscles when a person walks. One-way valves prevent reflux of blood back into the legs. As we age, our veins become less elastic and the valves can begin to malfunction. When this happens, the veins become distended and take on a ropy appearance that can be both unsightly and painful. The legs become swollen and ambulation is impaired. Endovenous ablation may provide a solution to the problem.
Risks and Benefits
Benefits:
Ablation is generally complication-free and safe.
Most of the veins treated are effectively invisible even to ultrasound 24 months after the procedure.
Patients report tremendous reduction in pain and discomfort after varicose veins are treated.
Most patients have immediate symptom relief and are able to return to normal activities within a day or two, with little or no pain.
Most patients are satisfied with the outcome.
Risks:
Some postoperative bruising and tenderness may occur, but may be alleviated by wearing a compression garment.
Some instances of thermal (heat) damage to nerves have been reported. This is rare and generally goes away in a short time.
Blood clots can form in the leg veins (thrombophlebitis), which can travel to the lungs (pulmonary embolism). This is an extremely rare occurrence.
