Endovenous Ablation

What is endovenous ablation?

Endovenous ablation is a minimally-invasive procedure for treating larger varicose veins. The treatment involves administration of heat or another type of energy directly into the affected vein. The vein walls become damaged and seal shut, cutting off blood flow to the vessel. The vein is eventually reabsorbed by the body, while blood is rerouted through healthy veins nearby.

Endovenous ablation is commonly performed using either laser or radiofrequency energy. The energy is delivered into the vein via a narrow catheter, using ultrasound technology to detect the affected vein and guide the catheter to its precise location. These technologies have become viable alternatives to more invasive procedures, such as ambulatory phlebectomy and vein stripping, for larger veins in some patients.

When is it done?

Endovenous ablation is typically done on larger veins of the leg. Many patients experience uncomfortable symptoms with these types of varicose veins, including heaviness or achiness in the legs, swelling and leg cramping at night. The procedure eliminates both the varicose vein and the symptoms that accompany it. In fact, most patients experience symptom relief almost immediately after the procedure is completed.

How does the procedure work?

Endovenous ablation is performed as an outpatient procedure in the office or surgical suite of a vascular specialist. Topical or local anesthetic may be provided to maximize patient comfort. Ultrasound is used to locate the affected vein and guide the catheter inside. Once the catheter is placed, heat energy is administered into the vein. Because the catheter is inside the vein, surrounding veins and tissue are not affected by the heat.

Once completed, the catheter is slowly withdrawn and a compression bandage applied to the site. The bandage will be replaced with a compression stocking prior to leaving the physician’s office, which aids in healing and promotes healthy blood flow to the area. The entire procedure may take anywhere from one to two hours to complete. No stitches are required and there is no scarring to worry about afterward.

What is the recovery like?

Patients are usually encouraged to get up and walk shortly after the procedure. Regular daily activities can be resumed the same day as the procedure in most cases, although strenuous exercise, hot baths and long car or plane trips should be avoided for a few days. Compression stockings are recommended for a week or two after the procedure, as well as elevation of the legs whenever possible.

Some patients experience mild swelling and bruising at the incision point, which dissipate on their own within a matter of days. Over-the-counter medication usually takes care of any discomfort felt after the procedure. If symptoms accompanied the affected vein, such as achiness or leg swelling, they usually begin to disappear right after treatment.

When will the results appear?

Patients will begin to see results within days after their procedure. It takes approximately one week for the treated vein to close completely. Follow-up examinations are performed during that first week to ensure the treatment worked as expected.

How many treatment sessions are needed?

In most cases, a single session of endovenous ablation will be sufficient to achieve desired results. However, the procedure may be combined with other procedures, such as sclerotherapy, to address additional veins in the same area. If endovenous ablation is recommended for more than one vein, the procedures are usually performed separately within two to three weeks of each other.

Will veins reappear after treatment?

Treated veins seal shut and disappear completely, so they cannot return. However, if faulty valves led to the formation of the varicose veins, that same condition may affect other veins in the future. There is no “cure” for venous conditions, but additional treatment may be recommended to address varicose veins that appear in the future.

What is the cost of endovenous ablation?

The cost of a single endovenous ablation procedure may run anywhere from $600 to $3,000. Cost varies based on the location of the physician, number of veins to be treated and type of medications used. Treatment of symptomatic varicose veins is often covered by insurance companies. If insurance coverage is not available, many physician’s offer financing options to make the procedure more affordable for patients.