Endovenous Ablation

Endovenous Ablation is a procedure, now commonly used to eradicate incompetent veins in legs. Classically, veins such as the greater saphenous and lesser saphenous veins were removed by vein stripping.

Laser technology as well as radiofrequency ablation technology now allows these veins and others (such as the anterior or posterior accessory vein for the thigh) to be eradicated without the need of venous stripping. There are many advantages to these new procedures. First they can be done in a clinic setting and hospitalization is no longer required. There is no need for general or spinal anesthesia or a need for sedation. One can walk in with no dietary restrictions and have the procedure done within an hour. After the procedure is completed one is immediately able to walk and leave with no delay. Normal activities can be resumed almost immediately.

Risks are usually minimal with this procedure. Bruising using radiofrequency occurs in less than 4% of patients. It is slightly higher with laser but still less common compared to venous stripping. Bruising is a temporary issue that resolves within a few weeks. Pain associated with the procedure rarely requires the use of narcotics.

Endovenous ablation requires entering a vein and passing a laser fiber or radiofrequency ablation device into the vein. This is done under local anesthetic through an extremely small incision in the skin. Using ultrasound, the devices are properly positioned in the vein. Next, a fluid is injected around the vein. This is predominantly a water solution with some local anesthetic. This process is associated with minimal discomfort. Ultrasound is used to guide this injection.

Some local anesthetic is also used in the skin at certain intervals above the vein to help facilitate injecting fluid deeper around the vein. Once the vein is well surrounded by fluid the procedure of eradicating the vein from within using laser or radiofrequency ablation is done. At this point the process is quite painless. Once the procedure is completed, bandages are applied to the small hole where the vein was entered through the skin. A tensor or compression stocking is then applied.

At this point the procedure is completed and the patient is able to immediately leave the office with no delay. Sometimes, additional procedures such as micro phlebectomy’s or sclerotherapy can be done during the same visit when indicated. Subsequent follow-up is done to check the success of the procedure and to ensure things have healed properly. Sometimes additional procedures can also be done on following visits as required.

If you should have any further questions regarding these procedures please feel free to contact us.