Endovenous Ablation

Endovenous ablation is a medical procedure carried out under local anaesthetic and is one of the treatment methods available to improve the appearance of varicose veins.

What is a varicose vein?

Varicose veins are large, swollen veins which are most likely to develop on the legs and feet. They are easy to distinguish from regular veins as they will be lumpy in appearance, and will usually be blue or purple.

All veins have valves inside them, which makes sure that blood only flows in the right direction around the body. Varicose veins develop when these valves leak inside the veins, causing blood to travel in the wrong direction, and then become trapped. This trapped blood is what causes the bulging and lumpy appearance associated with varicose veins.

Along with the appearance of varicose veins, there are other symptoms which will afflict those who suffer from the condition. These symptoms include:

  • Burning pain in the legs and feet
  • Throbbing in the legs and feet
  • Muscle cramp, often at night
  • Swelling of the feet and ankles
  • Skin which is dry and itchy over the affected area

Restless legs

Patients will often find that the symptoms may get worse in high temperatures, or after the patient has been standing for long periods of time. The symptoms may be temporarily relieved by resting and raising the legs, or by taking a short, gentle walk.

Who is most likely to get varicose veins?

There are certain factors which can increase the chance of developing varicose veins. These include:

  • Family history of varicose veins
  • Suffering from other health conditions
  • Pregnancy
  • Regularly standing for long periods of time
  • Being overweight
  • Age
  • Being female

As part of the natural aging process, veins lose elasticity as you get older. This means that older people are more likely to develop varicose veins.

When pregnant, the additional hormones can have an effect on the vein walls, making them more flexible. This can cause varicose veins to develop more easily.

Being overweight places additional pressure on the veins, which can cause veins to become abnormal. Having a job in which you stand for long periods of time can also have this same effect, as more blood will be gathered in the veins in the legs.

What is endovenous ablation?

Endovenous ablation is a medical procedure which is used to treat varicose veins. It can be used purely for cosmetic reasons, but has also been proven to be successful in relieving some of the other symptoms associated with varicose veins, such as:

  • Aches and pains in the legs and feet
  • Discoloration of the skin
  • Dry skin around the affected areas
  • Inflammation of the veins
  • Muscle cramps
  • Swelling of the feet and ankles

Endovenous ablation is a minor medical procedure. Patients are therefore usually treated and then allowed to leave almost immediately, with no admission to hospital required in normal circumstances.

An interventional radiologist, a doctor or other qualified healthcare professional will carry out the procedure at a hospital or clinic.

A topical anesthetic cream is usually applied to the area before the procedure begins. The legs will then be cleaned and sterilized.

The person carrying out the procedure will decide where the catheter will be inserted into the leg, and a small incision is made here in order to be able to insert the catheter. Once the vein has been located and mapped using ultrasound, the area will be numbed so that the patient will feel no pain.

Imaging, usually via ultrasound, will guide them up the vein and the catheter will be put in position in the affected vein. Once the catheter is in place, a radiofrequency electrode, or a laser fiber, will be inserted through the path made by the catheter. The tip of the electrode (or fiber) is then pushed just past the tip of the catheter so that it is exposed inside the abnormal vein.

The laser or the radiofrequency is then turned on, and the catheter is pulled back so that the device can travel down the length of abnormal vein. The physician will apply pressure to the vein to prevent bleeding and swelling and a small bandage will be applied to the site where the incision was made. This incision is usually very small and so will not require stitches.

This process is then repeated for each vein that is being treated. It is a low-risk, simple and quick procedure which will usually take no longer than an hour to complete. Most patients are back in work the next day.

Does it work?

Some medical practices claim a 95-98% success rate for endovenous ablation in the first three years after the procedure. After three years, there is a 5% chance that varicose veins will redevelop. Endovenous ablation can only treat the veins which are currently abnormal, there is a chance that other veins in the leg will develop the condition after the procedure has been completed. In this case, patients would have to come back at a later date to have the newly abnormal veins treated.

Does endovenous ablation hurt?

The procedure is carried out under the effects of local anesthetic, so the affected areas will all be numbed. Patients are likely to experience some pain and discomfort after the effects of the local anesthetic have worn off, but this pain will wear off during the recovery period.

Are there any side effects to endovenous ablation?

After the procedure, most patients will experience swelling and bruising in the areas which have been treated. Hard lumps are likely to form in the legs, which will be swollen and tender to the touch.

There are certain things which will help relieve these side effects of endovenous ablation. Heat pads can help to reduce selling and provide relief from aches and pains. Applying a heat pad to the affected areas for up to half an hour, 2 or 3 times a day can aid recovery and reduce the severity of any side effects. Taking over-the-counter pain relief will also help make recovery more comfortable.

You should be provided with a pair of compression stockings after the procedure. These should be worn overnight on the first night after the procedure. Once you have removed any bandages as instructed by your doctor, you will then need to wear the stockings for 7 days, but you can take them off to sleep.

Try to avoid the following until fully recovered:

  • Strenuous exercise
  • Exposing the affected areas to sunlight
  • Lifting heavy objects
  • Standing for long periods of time

As with all medical procedures, there is a small possibility of infection after having had endovenous ablation treatment. If you start to develop any of the following symptoms, visit your doctor straight away as they could be a sign of infection:

  • Chest pain
  • Difficulty breathing
  • Fever/chills
  • Muscle weakness
  • High temperature
  • Severe pain in the affected areas
  • Excessive swelling or redness which will not go down.