State-of-the-Art, minimally-invasive and maximally comfortable. This procedure permanently heat-seals problematic veins shut and allows normal vein flow to resume. Symptom relief and some cosmetic benefits are often noted within weeks.
Endovenous thermal ablation techniques utilize different methods to safely and permanently heat-seal improperly functioning veins. Different methods exist, including Laser ablation, Radiofrequency Ablation and even Steam ablation. In my practice, I utilize Endovenous Laser Ablation using a 1470nm wavelength laser. Research and my own experience have shown this to be a method that is both very safe and very effective at closing off incompetent segments of superficial veins.
Without getting into too detailed a description (no worries for those more sensitive readers!), the treatment isn’t much more complicated than getting an IV. In this case, an IV is started under sterile technique using ultrasound guidance. Rather than using the IV catheter to deliver medicine or fluids, I use it to deliver a small, specialized, delicate laser fiber to the segment of incompetent vein.
Once the fiber is confirmed by ultrasound to be properly placed, a dilute local anesthetic solution is gently instilled in the area around the vein. The purpose of using this solution is threefold: It acts to compress the vein walls against the IV catheter/laser fiber to ensure effective heat-sealing; the cool (temperature-wise…but I guess in the “Fonzie” sense of being fascinating, too) fluid acts as a “heat sink” to absorb the energy from the laser and protect the areas surrounding the vein; finally the fluid keeps patients pain-free during the procedure. Ironically, the only discomfort associated with the procedure is associated with placing local anesthetic to ensure that patients won’t feel any discomfort thereafter. Fortunately the discomfort is kept to a minimum and is relatively short-lived.
After the local anesthetic phase is complete and proper fiber placement is again checked by ultrasound, the final phase is ready to begin. The laser is turned on and slowly retracted, along with the IV catheter containing it, out of the vein. From the patient’s perspective this part is pretty boring. You shouldn’t feel any discomfort whatsoever. From my perspective, it’s fun and fascinating…which tells me that I must be in the right line of work! While not all physicians do so, I prefer to watch the laser in action under ultrasound to ensure that the treatment is proceeding properly and to assist in encouraging the closure of connecting points to incompetent side branches whenever possible. For other physicians reading this: yes, I know it’s like watching ice melt…but if enduring watching something tedious on a screen might lead to better outcomes, so be it! Anyway, it’s probably better than most of the things on TV today…and there’s no commercial interruptions!
Once the laser and IV catheter are safely removed, the leg being treated is gently cleaned. The tiny wound is dressed. It is so tiny that it does not require sutures but rather specialized Steri-strip bandages. Gauze and tape are placed over the area that has been treated. Finally, a compression stocking is placed over the gauze and tape. Not long thereafter you are on your way. There is no downtime. You may return to work if you need to do so (unless, perhaps if you are a pilot, flight attendant, astronaut, etc). If you are someone who works at a rival vein clinic, please do not return to work. Ever. [I kid…it’s what I do]
I encourage all of my patients to stay active. The mantra is “go,go,go”. We will discuss the details of post-procedure recommendations more fully after your procedures are performed. As always, all questions are encouraged.