|
Endovenous Laser Ablation is a minimally invasive option for treating saphenous vein incompetence (leaky valves). The first stage of your procedure will involve inserting a laser fiber at the level of the knee or higher (for the greater saphenous vein) or in the calf (for the lesser saphenous vein), under ultrasound guidance. Your leg will be anesthetized with a local anesthetic agent. Then the laser will fire and at the same time be slowly withdrawn destroying the vein.
Ambulatory Phlebectomy is a minimally invasive procedure usually done at the same time as the endovenous laser ablation. Local anesthetic is used and very tiny incisions are made into the skin and the large protruding veins are teased out and the punctures are closed with small pieces of surgical tape.
Following both of the above procedures compression stockings will be required for three days, day and night, and then three weeks during the day only.
Approximately three days after the procedure an ultrasound will be performed to insure that the vein is occluded.
Varicose veins and spider veins are chronic and recurrent conditions. The variety of treatment available will not offer a cure, but rather control of the condition. Surgically removed veins and veins that are sclerosed will not return. However, your tendency to develop new veins will not be changed or eliminated by this procedure or any other treatment.
All surgical interventions carry an inherent risk of infection, allergic reaction, bleeding and anesthetic complications including cardiopulmonary complications. Below are possible risks and side effects that are specific to endovenous laser ablation and ambulatory phlebectomy.
Allergic Reaction: Very rarely, a patient may have an allergic reation to the anesthetic agent. The risk of this is greater in people that have multiple drug allergies.
Pain: Patients may experience moderate to severe pain following the procedure. The leg may be tender to the touch after treatment, and an uncomfortable sensation may run along the vein route. Some people describe the discomfort as a “Charlie horse” feeling in their thigh. This discomfort is usually temporary.
Swelling: Usually occurs after treating veins in the leg. It usually resolves in a few days but may last up to a few weeks, especially after the treatment of particularly large veins. Wearing the compression stockings and taking Advil, Tylenol, Motrin, or Ibuprofen will help to decrease inflammation.
Skin Burns: Utilizing laser therapies carries a risk of skin burns, although a very minimal risk, it is still a risk.
Damage to the eyes: Laser therapies can cause damage to the unprotected eye. You will be provided with safety goggles to protect your eyes.
Deep Vein Thrombosis (DVT): This is a rare complication but includes the associated danger of a possible pulmonary embolus (a blood clot carried to the lung) and post-phlebitic syndrome, resulting in permanent swelling of the leg.
Transient hyper-pigmentation: Patients who have the endovenous laser ablation may notice some discoloration after treatment. The discoloration is almost always transient and will resolve within three months. In rare cases this discoloration may persist up to a year or longer.
Nodularity: Nodules or bumps at the sight of the vein removal may persist up to a year. This occurs when there are pieces of the vein that did not get completely evacuated during the ambulatory phlebectomies. These veins get scarred and become hard. With time the body will absorb them and the bumps should disappear. They can also be injected with a sclerosing agent at an office visit.
Nerve Trauma: Occasionally there can be trauma to surrounding nerves, which can result transient numbness that will resolve on its own in time. In rare instances the numbness can be permanent.
Spider Veins: These can occasionally occur along the path of the treated vein. These can also be treated in the office with a sclerosing agent.
I am aware that in addition to the risks listed above, there are other risks that may accompany any surgical procedure, such as blood loss, infection, and inflammation in the venous system with the formation of a thrombus (clot), post-op bleeding, and nerve trauma that may lead to temporary or permanent numbness.
Alternative Treatments: Because varicose veins are not a life-threatening condition, surgical treatment is not mandatory in every patient. Some patients get adequate relief of symptoms from wearing graduated compression stockings.
Surgical stripping may also be used to treat large varicose veins. This must be done in a hospital setting under general anesthesia. Risks of vein stripping are similar with the additional risk of general anesthesia. Surgical stripping is much more painful and may require spending time in the hospital.
The only other option is to receive no treatment at all.
|
