Varicose Vein Ablation Therapy

WHAT TO EXPECT ON THE DAY OF YOUR VEIN
PROCEDURE?

  •  
  • You will be at the office for
    about 2 hours
  • The procedure takes about 30
    min
  • The rest of the time involves
    checking in, prepping, imaging, bandaging
  • A relaxing medication is
    prescribed the day before by our office. Take it as prescribed
  • Shower and shave the operative
    leg the night before
  • Do not use lotions, creams.
  • You will need a ride to and
    from the office; if you decide not to take any sedatives for the procedure, you
    may drive yourself
  • Bring your bandages/compression
    stockings
  • Take all your medications.

Procedures 

The treatment of venous
insufficiency starts with Ablation of large, deeper veins: Great
saphenous vein and Small Saphenous vein. 

RFA ablation and Laser
ablation are performed 

  • The large, deeper veins are located inside your muscle, not
    visible to you, and detected by ultrasound. 
  • These large veins should always be treated first, before the
    spider veins; not treating them first will lead to recurrence of the
    superficial, cosmetic, spider veins, in the same location or different 
  • Most insurances cover these procedures, named ablations
  •  
  • Ablations are medical
    treatments, aiming to decrease venous complications, such as clots, cellulitis,
    and to relieve symptoms. 
  • They do not result in major
    improvement of cosmetic appearance, unless the disease is caught very early
  • The second part of the
    treatment consists of “cosmetic” therapy of Spider veins and Varicosities.

Procedures performed are

  • Laser cosmetic sclerotherapy
  • Chemical sclerotherapy
  • Phlebectomy
  • Being directed towards cosmetic
    appearance, these procedures are not covered by insurances 

Cosmetic laser therapy, Dornier
laser

Vein procedures are performed
under strict sterile conditions and under Ultrasound guidance

Ultrasound imaging is locating
the vein and the desired position of the catheter tip to begin the treatment

Local anesthesia is given at
the point of entry into the vein, felt as a bee sting and burning sensation.

The ablation catheter

The catheter is inserted into
the vein and advanced under Ultrasound guidance to the uppermost segment
of the vein- the groin or behind the knee, depending which vein is treated

Diluted anesthetic fluid is
injected into the area surrounding the vein

This numbs the leg providing a
layer of protection outside the vein

Ultrasound image of the tumescent fluid surrounding the vein

The catheter delivers heat
(RFA) or bursts of energy (laser) to the vein wall, shrinking and collapsing
the vein

RFA and Laser ablations follow
the same technique, using different types of catheters. Choosing one technique
over another depends on your vein anatomy, size, tortuosity. Both techniques
end in the same results.

Vein ablation

Love your healthy legs 

WHAT
TO EXPECT AFTER A VEIN PROCEDURE?

Post
Vein ablation

  • Wear the compression hose
    continuously for 2 days, then during all waking hours for 2 weeks.
  • Elevate the treated leg
    whenever seated.
  • Walk every hour for a few
    minutes. Also add a 20-30-minute walk daily if able. Walking is strongly
    encouraged.
  • Ambulatory Phlebectomy: 
    you can remove the Coban (disposable ace wrap) in the first 24 hours.
    Leave the support hose on continuously for the 2 day period then for 2
    weeks during waking hours.
  • Band-Aids, Tape, and Gauze:
    Remove the tape and gauze after 1 day.
  • Take Ibuprofen 400 mg in am and
    400 mg pm, for 5 days; this will decrease the normal inflammatory response
    and discomfort post procedure.

Post
procedure symptoms

  • Pain:  may experience mild
    to moderate discomfort following the procedure. The leg may be tender to
    the touch after treatment; it is normal to experience some tenderness or
    bruising in the areas where local anesthesia was administered. This pain
    responds well to Ibuprofen
  • Transient bruising:  some patients
    may notice some mild bruising or discoloration after treatment. This
    discoloration is almost always transient and will resolve in about 3-4
    weeks. In rare cases, this darkening of the skin may persist up to a year.
  • Leg/Ankle Swelling: may occur
    especially after treating large varicose veins. It usually resolves in a
    few days but may last a few weeks. Wearing the prescribed compression hose
    and elevation will help lessen the swelling. If uncomfortable, a small
    dose of diuretic will be prescribed 
  • Some patients may
    experience a “pulling” or “tight” sensation 1-3 weeks after the procedure.
    This is the effect of the treated area healing. Occurs mainly when treated
    vein is close to the skin and there is minimal fat tissue around.
  • Discoloration of the skin along
    the treated veins. This may last several months.
  • Superficial thrombophlebitis: .
    You may feel a small cord under the skin, with redness and warm
    sensation. Call us and ant inflammatory drugs such as ibuprofen,
    antibiotics, or even blood thinners may be prescribed for a short period
    of time

Restrictions
after the procedure

  • Driving: You need someone to
    drive you to and from the office on the day of the procedure, due to
    sedatives administered. Drive as tolerated after the first day.
  • Activities: You should be
    walking hourly. 
  • Heavy Lifting Restrictions: No
    heavy lifting or straining for 1 week after the day of the procedure.
  • Bathing: Sponge baths only for
    the first 1 day. 
  • Work: You may return to work
    next day after the procedure.
  • Sports/Exercise: 1 week from
    the day of the procedure.
  • Sexual Activity: Whenever
    comfortable.
  • Diet: Resume normal diet.
  • Flying: Allowed 1 week after
    the procedure.  We advise compression stockings for flight longer
    than 4 hours.