Laser/Radio Frequency Ablation
Varicose Veins are a common condition. There are multiple treatments available to treat varicose veins and venous insufficiency. Modern technology means that there are now minimally invasive treatments for varicose veins which do not require incisions or general anaesthetic.
Planning for endovenous treatment usually requires an ultrasound. This determines which parts of the system are incompetent (refluxing) and causing the varicose veins. This allows a complete treatment to be planned.
The endovenous laser treatment has three main components.
Before the procedure, a marking ultrasound is performed. Along the course of the vein, local anaesthetic ointment is applied. A blood thinner is usually administered before the procedure with a small injection.
The first component uses a laser fibre. Under local anaesthetic and under ultrasound guidance, a needle is placed in the incompetent vein usually at the level of the knee. A thin guidewire is placed through the needle into the incompetent vein. Over the wire a thin tube (called a sheath) is placed and through this a laser fibre is positioned. The fibre is placed 2cm below the junction between the incompetent vein and the main venous system. More local anaesthetic is instilled along the course of the incompetent vein under ultrasound guidance. The sheath is then removed leaving the laser fibre. The laser is activated, and slowly withdrawn, the heat from the laser fibre blocking the target vein. The process is monitored under ultrasound. Once the entire vein has been blocked, the fibre is withdrawn.
The second part of the treatment involves treating the varicose veins themselves. This is done using a chemical which causes the varices to thrombose called sclerosant. The sclerosant is injected into the varices under ultrasound guidance and milked into the other varices. Several injections may be required. The sclerosant causes the varices to thrombose, and over a period of weeks (or months in the case of large veins), the body removes this so they are no longer visible.
The third component of the treatment commences immediately and involves compression. This is initially in the form of a compressive bandage and a compression stocking. In 3 days the compressive bandage is removed, but the compression stocking is used for a further 2-3 weeks. The compression helps the veins thrombose and importantly the walls to adhere so they cannot fill again and therefore cannot be seen. Thirty minutes of brisk walking is undertaken immediately after the procedure.
Check ultrasound scans will be arranged in the following weeks, and it may be necessary for further ‘touch-up’ injections of sclerosant in the following weeks to ensure a complete treatment. This is part of the package.
Complications are uncommon but can include allergy, infection, recurrence. There is a small risk (1-2%) of Deep Venous Thrombosis from the procedure, which requires the use of blood thinner for 3-6 months in some cases. There is a very rare complication of stroke from the sclerosant use reported in the literature.
To learn more, please click here to view Information Sheet.
Feel welcome to view the following YouTube videos;
VNUS Closure Procedure Using Closure FAST Catheter
VNUS Closure Procedure