Venous Ablation
What is Venous Ablation?
It is a minimally invasive technique that destroys varicose leg veins. The treatment sends bursts of radiofrequency or laser energy through a catheter; the resulting heat intentionally destroys vein wall tissues along the length of the vein. The exciting new technique is revolutionizing the treatment of venous reflux in legs. Let us find out more about venous reflux and the venous ablation procedure.
In the normal situation, valves in the vein wall keep blood flowing toward the heart. When the valves are damaged, blood can flow backwards, dilating the vein and pooling in the leg. When the vein is ablated, normal blood flow direction is restored.
Vein ablation relieves symptoms associated with painful varicose veins, improves the appearance of the legs, and has a low risk of side effects. Varicose veins occur when weak veins near the surface of the leg stretch, bulge, and twist. Varicose veins can be visible through the skin.
Left untreated, varicose veins can cause
- Fatigue
- Aches
- Swollen ankles
- Scaly, dry skin
- Leg sores
Varicose vein ablation destroys varicose veins with bursts of radiofrequency or laser energy. Varicose vein ablation causes little to no pain, leaves no scarring, and is as successful as surgery for varicose veins.
When is it indicated?
- Varicose vein ablation may be indicated in patients who
- Have chronic venous insufficiency
- Suffer from skin problems on the leg
- Wish to improve the appearance of varicose veins
- If varicose vein ablation is used cosmetically, it may not be covered by health insurance
Pre-Treatment Guidelines
First, the physician examines the legs using duplex ultrasound to decide whether varicose vein ablation is appropriate and is likely to improve symptoms. The patient does not need to do any special preparation for the procedure.
Who is eligible?
Healthy patients with varicose veins are eligible for varicose vein ablation.
Pregnant women who want to treat varicose veins should wait 6 weeks after giving birth before scheduling therapy, because pregnancy-induced varicose veins may fade.
Risk Factors for Possible Complications
Having thin or muscular legs or veins close to the surface of the skin may increase the risk for minor burns from the procedure.
What to Expect
In radiofrequency ablation, heat seals the vein as the physician withdraws the catheter. Varicose vein ablation is performed as an outpatient procedure under local anesthesia. Immediately before the procedure, the physician will perform duplex ultrasound to map the leg veins. Next, the physician will mark the varicose vein on the skin. Although the techniques for radiofrequency ablation and laser ablation vary slightly, both treatments destroy tissues with heat. Radiofrequency energy comes from electric and magnetic energy and laser energy comes from light.
The physician passes a catheter (long, thin tube) through a small nick in the skin above the vein and moves the catheter to the end of the vein. The physician activates a radiofrequency generator or sends laser pulses through the catheter as he or she slowly retracts it. The heat destroys the tissue along the length of the vein. The vein collapses and is eventually reabsorbed by the body. Occasionally, the patient may experience brief pain if the radiofrequency catheter or laser heats tissue near a nerve. This pain disappears once the physician moves the catheter. The procedure takes about 60 minutes and may relieve symptoms immediately.
Post-Procedure Guidelines and Care
Patients can resume normal activities immediately after the procedure but should avoid strenuous activities such as lifting more than 10 pounds for 1 to 2 weeks.
Thigh-high prescription compression stockings are applied immediately after the procedure. The patient wears the stockings for 1 week.
Possible Complications
- Minor bruising, burns, or soreness may occur after vein ablation
- Few serious complications have been reported
- In theory, any procedure that destroys vein tissue can trigger deep vein thrombosis (DVT) in patients who are susceptible. However, no cases of DVT following vein ablation have been reported to date
- Less than 10 percent of varicose veins treated with vein ablation return after 2 years
Lifestyle Adjustment
- The following lifestyle changes help prevent varicose veins
- Avoid crossing the legs at the knees when sitting
- Refrain from wearing high heels
- Avoid clothing that is tight around the groin or calf
- Elevate the legs or walk around frequently during the day
What is venous reflux?
Venous stasis is a common condition in which the flow of blood from the legs to the heart is abnormal. Most people assume that the heart pumps blood out to the legs and then pumps it back. That’s only half right. Actually, the heart only pumps the blood out. Leg muscles pump it back. Every time a leg muscle tightens (called contraction), it squeezes the leg veins flat. Blood is pushed through the veins like toothpaste being squeezed from a tube. When everything is working normally, a series of one-way gates (called valves) makes sure that the blood can only move one direction: toward the heart. However, when the valves are damaged, the “muscle pump” doesn’t work (imagine a busy intersection with no traffic signals). This condition is called reflux and most often involves a large leg vein called the saphenous vein. When saphenous reflux is present, blood simply pools in the legs, causing everything from unsightly varicose veins to severe pain and ulceration of the skin.
How is it treated?
The easiest treatment is to wear compression stockings. These special socks gently squeeze the leg, helping the muscle pump to work more effectively. If compression stockings do not help, the abnormal vein must be eliminated. Historically, this has been done with a surgical procedure called “vein stripping.” It can now be done with a non-surgical technique known as venous ablation. The laser fiber is inserted into the dilated vein. It is then activated and withdrawn, causing the vein to close down and become sealed off.
What is venous ablation?
Venous ablation eliminates the abnormal, refluxing vein by sealing it closed. The vein does not actually have to be removed from your body, as in vein stripping.
How is venous ablation done?
Through a tiny incision at the knee (the size of a pencil point), a small tube is placed into the saphenous vein. Then, a laser or radiofrequency fiber is passed through the tube into the vein. Once in place, the fiber is activated, delivering localized heat to the vein wall. In response, the vein closes down and becomes permanently blocked.
Don't I need my veins?
Yes, veins are necessary for blood return from the legs to the heart. Venous ablation treats only the abnormal vein that is allowing blood to flow backwards. Since this vein has lost its ability to carry blood in the correct direction, it is no longer needed.
Is it painful?
Through a tiny incision at the knee (the size of a pencil point), a small tube is placed into the saphenous vein. Then, a laser or radiofrequency fiber is passed through the tube into the vein. Once in place, the fiber is activated, delivering localized heat to the vein wall. In response, the vein closes down and becomes permanently blocked.
How quickly does it work?
The ablation procedure closes the vein immediately. The improvement in blood flow happens right away. However, it may take a few weeks for the original symptoms to go away, and large varicose veins may need some additional minor treatment. Marked improvement is observed in the varicose veins, which are common viable signs of venous reflux.
Will it work for me?
If your saphenous vein has reflux, venous ablation will probably help to eliminate your symptoms. The best way to test for reflux is by ultrasound examination. We offer a comprehensive ultrasound screening for saphenous reflux, book your appointment for early diagnosis and treatment.
