The preferred method of treatment for most significant varicose veins for most modern Vein Specialists is Endovenous Ablation. This modern technique removes the need for a general anaesthetic in most cases, can be performed with the patient awake, and allows the patient to walk out of the procedure room within moments of completion of the procedure. Additionally, there is no need for large incisions or cuts in the skin and very little in the way of post procedure pain or discomfort.
See an animation of how RF ablation works here.
The patient walks into the procedure room and lies on the couch. Using an ultrasound machine, the vein is identified and, using the live images, a needle passed into the vein to be treated as far down the leg as possible. Once secured, and the position of the needle is confirmed, a wire is passed through the needle and then a plastic tube passed over the wire into the vein. Again with the ultrasound guiding placement, a heat probe is passed through the plastic tube to the top of the vein to be treated. The Vein Specialist then injects local anaesthetic fluid around the heat probe and down the vein to be treated. This usually need between 4 and 10 injections depending on the length of vein to be treated. Once the Vein Specialist is happy that the whole area is numbed, and the position of the probe is checked, the heat is delivered to the vein from inside, heating and destroying the cells lining the vein along its length.
Following the procedure, a long compression stocking is placed over the treated leg and the patient is sat up and allowed home after a few minutes recovery period.
Patients are required to wear their compression stockings for the first 48 hours continuously to prevent excessive blood from clotting within the treated veins. This helps the treatment, and reduces the bruising swelling and inflammation after the procedure. The stockings should be worn during waking hours for a total of two weeks following the procedure. Thereafter they can be worn for comfort, or removed completely if preferred.
After the procedure the patient can expect some bruising and inflammation, but pain and discomfort is mild. It usually responds well to simple over-the-counter pain relief. The bruising settles over the next few weeks, sometimes being replaced by a faint tanning over the treated vein. This becomes imperceptible with time for most and is dependent on the extent of bruising suffered. Some patients have a persistent numbness along the line of injections this is usually temporary, slowly recovering over the following months.
A follow-up is usually planned for 6 to 8 weeks after the procedure. This helps to establish what the benefit from treatment has been and for most of the bruisung to have settled. Occasionally, there are some remnant veins that need further treatment using Injection Sclerotherapy or Ultrasound Guided Sclerotherapy.
The main risks for this treatment are that there is injury to the skin where the vein is treated, that there is extensive bruising and inflammation, infection along the injected vein, or the development of Deep Vein Thrombosis. Significant complications are rare, and are less frequent than with conventional surgery. Where possible, Endovenous Ablation is the preferred choice of treatment for varicose veins.
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