Resources

Q

What are varicose veins?

A

Normally, 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. 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 unsightly and cause pain, swelling, or itching. Standing and walking may become uncomfortable. Some of the causes of varicose veins are: age, heredity, pregnancy, and weight gain. Endovenous laser ablation may provide a solution to the problem.

Q

What is endovenous ablation of varicose veins?

A

Endovenous laser ablation is a less invasive alternative to standard vein stripping for patients suffering from varicose veins. The procedure treats the vein(s) from the inside using heat energy from a laser source to seal the afflicted vein(s). Local anesthesia is all that is required.

Interventional radiologists perform this procedure on an outpatient basis and when compared with traditional surgical techniques, endovenous laser ablation is as effective, has fewer negative outcomes, and is associated with less pain during recovery. There are virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions.

Q

What happens during the procedure?

A

Unlike older, more invasive procedures that strip veins from the leg through the use of small incisions, endovenous laser ablation uses a catheter, or small tube, which is inserted through a small nick in the skin. Only local anesthesia is required.
The leg being treated will be sterilized and covered with a surgical drape. A local anesthetic 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.


The procedure starts by advancing the catheter inside the vein up to the top of the leg. Anesthetic is injected along the vein(s) being treated. Energy is applied as the catheter is slowly withdrawn. This heats and seals the vein closed. By the time the heat energy is delivered, the vein will be numb and there should be no pain. Throughout the procedure, the radiologist guides the catheter using the external ultrasound wand positioned directly outside on the surface of the leg.

Q

How long does the procedure take?

A

The procedure takes about 45 minutes to one hour right in our vascular clinic.

Q

What happens after the procedure?

A

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 resumed, with the exception of lifting heavy objects or prolonged sitting (for instance a long plane or bus trip).

Four weeks after endovenous laser ablation, the radiologist will follow up using ultrasound to ensure that the procedure was successful at treating the vein(s) in the leg. Minor additional procedures to treat associated veins may be necessary.

Q

How long do the effects of treatment last?

A

In clinical trials, laser treatment has proved to be 97% effective. Therefore, you should experience no recurrence in the veins that have been treated. However, you may want to have follow-up procedures to obtain the best cosmetic results.

Q

How safe is endovenous laser ablation?

A

Medical lasers work by delivering light energy to the targeted tissue with extreme precision so as not to harm the surrounding tissue. Lasers are proven to be safe and effective for treating many health issues. In the hands of a skilled physician, lasers offer far less risk and complications than conventional surgery.

Endovenous laser ablation is generally a complication-free and safe procedure. Most patients report their symptoms are greatly reduced after the varicose veins are treated.Many patients experience bruising and tenderness after the procedure. Wearing compression stockings and taking anti-inflammatory medication may take away some of the tenderness. In addition, there have been some reports of heat damage to nerves, although this is rare and often goes away over time. Lastly, it is possible for blood clots to form in the leg veins. If this occurs, the clot can travel to the lungs causing a pulmonary embolism. However, this reaction is extremely rare.

Q

Will I need repeat procedures to maintain or improve my results?

A

Endovenous laser ablation is successful at closing the treated vein(s) nearly 100 percent of the time. Small dilated branches that persist 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.