Endovenous thermal ablation

Overview

Endovenous thermal ablation, also known as endovenous laser or radiofrequency therapy, is a minimally invasive procedure designed to address varicose veins—enlarged and twisted blood vessels typically found in the legs, feet, and ankles. In this treatment, healthcare providers use a laser or high-frequency radio waves to seal off the varicose veins, facilitating the restoration of normal blood flow by allowing healthy veins to take over. This procedure aims to alleviate the symptoms associated with varicose veins by efficiently closing off the affected vessels.

Reasons for undergoing the procedure

Endovenous thermal ablation is a procedure for medium to large varicose veins in the legs. These veins often appear as bulges in a bluish or skin-colored tone.

Symptoms of varicose veins:

• Achiness
• Feeling of heaviness in legs and feet
• Itching
• Leg cramps, especially at night
• Swelling

Varicose veins happen when valves in leg blood vessels weaken, causing blood to pool. The procedure shrinks varicose veins, redirecting blood to healthier veins. This makes treated veins invisible and not palpable.

People may choose removal for cosmetic reasons. Also, treating varicose veins can prevent complications like deep vein thrombosis, skin sores, or bleeding.

Risks

Endovenous thermal ablation is generally considered safe when performed by an experienced healthcare professional. Potential side effects may include pain, bruising, numbness, and in rare cases, blood clots in the legs. If you experience any side effects following the procedure, it is expected that they will typically resolve within a few weeks.

Before the procedure

Prior to scheduling your procedure, it is essential to inform your healthcare provider about all medications, vitamins, and supplements you are currently taking. There may be a need to discontinue specific medications before the procedure, and your provider will provide detailed instructions regarding any necessary changes. Additionally, your healthcare provider will discuss your symptoms and address any other health conditions you may have during the consultation.

During the procedure

Before your procedure, your doctor will administer anesthesia to ensure you don’t feel any pain. This includes:

• Local anesthesia: Numbing the area around your vein.
• Sedative medications: Helping you relax during the procedure.

During the endovenous thermal ablation:

• Locating the vein: Using ultrasound to find your vein.
• Small incision: Making a small cut in your leg, typically below the knee or near the ankle.
• Catheter insertion: Placing a thin tube (catheter) into the incision and guiding it into your vein.
• Applying heat: Introducing a thin tool through the catheter to your vein. This tool, using laser or radiofrequency waves, generates heat, permanently sealing off the vein.
• Numbing fluid: Injecting a numbing fluid around the vein for anesthesia.
• Closing up: Applying a bandage over the incision; stitches are usually not necessary.

The entire procedure typically takes about an hour, with the actual laser treatment lasting three to five minutes. It’s an outpatient procedure, allowing you to go home on the same day.

After the procedure

To facilitate optimal healing of the incision, adhere to the following guidelines:

• Activity restriction: Refrain from engaging in activities such as swimming or hot tub usage.
• Leg elevation: Elevate the treated leg whenever possible to promote recovery.
• Incision maintenance: Ensure the cleanliness and dryness of the incisions to minimize the risk of complications.
• Compression garments: Consistently utilize compression socks as prescribed to support the healing process.
• Follow-up assessment: Schedule a follow-up appointment after one week for an ultrasound examination to verify the proper closure of the treated vein.

Outcome

After your procedure, make sure to arrange for someone to drive you home. To support your recovery, follow these guidelines:

• Avoid strenuous exercise: Wait until your provider gives the green light before engaging in strenuous physical activity.
• No flying for two weeks: Steer clear of air travel during the initial two weeks after the procedure.
• Prioritize sleep: Ensure you get sufficient sleep to aid your body in the healing process.
• Move frequently: Make it a point to move and walk around regularly throughout the day.

Returning to normal activities:

• You should be able to go back to work a few days after the procedure.
• If your job is physically demanding and requires prolonged standing, check with your provider about taking additional time off.

In the event of potential complications, such as a blood clot, promptly seek medical attention if you experience:

• Chest pain
• Hemoptysis (coughing up blood)
• Tachycardia (fast heart rate)
• Sensation of tension or pulling in the calf
• Lightheadedness or fainting
• Exacerbation of pain or tenderness
• Skin discoloration
• Swelling
• Respiratory difficulties