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The development of varicose veins is a common problem occurring in up to one third of adults. Left untreated, varicose veins can result in leg swelling, leg pain, or heaviness or even skin ulcerations. Varicose veins are most commonly the result of poor function of the system that normally shunts blood from the superficial veins to the deeper larger veins of the thigh and calf. When this system fails the blood pools in the superficial veins resulting in the varicose veins. Historically, this condition has been treated surgically be removing the saphenous vein completely. This procedure is commonly referred to as saphenous vein stripping. A new, highly effective alternative to saphenous vein stripping is saphenous vein ablation. In saphenous vein ablation the vein is not removed but rather treated so that it will scar down. Two different ways to ablate the saphenous vein are available. One uses a radio frequency probe to heat the vein wall, the other method is to use a laser. While both techniques are effective, we prefer the laser system.
How is the procedure performed?
The procedure is performed by making a small puncture into the vein at the level of the knee. The laser is then threaded through the vein to the level of the groin. The tissues surrounding the vein are then injected with an anesthetic solution for pain control and to protect the surrounding structures from heat damage. The laser is then turned on and slowly backed down through the vein. The thermal damage to the vein wall causes the vein to scar down immediately. Because of the anesthetic and lack of nerve endings inside a blood vessel, patients do not feel the laser. After the procedure, the puncture is dressed and a stocking is placed. This is to be worn for three days.
FAQs:
Is the procedure safe?
Yes. There is a small (less than .5%) risk of infection or superficial burns. Some bruising is to be expected, but significant bleeding is distinctly uncommon.
What kind of tests need to be done prior to the procedure?
An ultrasound evaluation of the veins of the legs is necessary in order to be sure the patient is a good candidate. Some patients will be asked to attempt a trial of compression stockings prior to the procedure.
How long does the procedure take?
While the procedure takes around 45 minutes, you can expect to be at the hospital for well over half the day. We typically ask a patient to arrive at least 1 hour ahead of time and the typical waiting period after the procedure is 2-3 hours.
Will all my varicose veins resolve with this procedure?
Not always. While most of the varicose veins will become much less prominent, some may remain visible after the procedure. If this is the case, additional procedures such as sclerotherapy (in which the individual residual varicose veins are injected with a substance to cause them to scar and shrink) are available.
Will I be sedated?
While many centers perform this without sedation, we prefer to administer a sedative.
Will I be in pain after the procedure?
You may experience some mild bruising from the procedure, but sharp or deep seated pain is unexpected. Many patients experience a tugging sensation in the groin area for several weeks after the procedure as the vein scars down.