What Happens During Varicose Vein Ablation?

Varicose vein ablation is a safe and effective treatment for varicose veins. With success rates in the 90% to 99% range, the procedure has quickly become popular in the United States. Compared to surgery, it has a lower risk of complications and a faster recovery time. The procedure also causes fewer possible side effects.

Generally, varicose vein ablation treats large varicose veins causing symptoms like pain, fatigue, or swelling. Varicose veins of that severity are often caused by leaky valves in one of three main veins in the leg. Varicose vein ablation eliminates the problem vein that is the source of visible varicose veins, and the body immediately redirects the blood through healthier veins.

The four types of varicose vein ablation use different methods to seal off the problem vein:

• Microfoam injections use a chemical solution.
• VenaSeal uses a medical adhesive called cyanoacrylate.
• Endovenous laser ablation (EVLA) uses heat from a laser.
• Radiofrequency (RF) ablation uses heat from radio waves. 

A Look at What Happens During Varicose Vein Ablation

Most varicose vein ablation treatments are performed by a vein specialist at their office. The procedure usually takes an hour or less and involves the following steps.

1. Preparation

The area to be treated may be shaved if necessary. The skin is cleaned and sterilized by antiseptic swabs. If receiving laser treatment, you will be given protective eyewear that looks like a pair of sunglasses.

2. Ultrasound

The vein specialist uses duplex ultrasound to look at the blood flow in the vein to be treated. Ultrasound causes no discomfort and gives the doctor important information about the condition and position of your veins. 

A gel is applied to the area to be examined. A small, handheld device called a transducer is placed on top of the gel. The transducer emits sound waves at a frequency humans cannot hear and picks up the echoes as the sound bounces off your veins. A display monitor shows an image of your veins and the blood flowing through them.

3. Placement 

For microfoam injections, this is the last step. With ultrasound guidance, the vein specialist injects the medication directly into the problem veins. Multiple injections are usually needed. A bandage is applied and the procedure is complete.

For VenaSeal, RF ablation, or EVLA, a local anesthetic or numbing medicine is applied, and a tiny cut is made in the skin. A catheter for VenaSeal or RF ablation — or laser fiber for EVLA — is inserted into the vein through this incision and guided into place using ultrasound. Catheters and laser fibers are thin and flexible, so this step is not usually painful. 

4. Tumescent Anesthesia

This is typically the most uncomfortable stage of EVLA and RF ablation. It is not necessary for VenaSeal. 

A solution containing a local anesthetic is injected at multiple points along the vein. The solution has three purposes that all aim to make the treatment more effective: 

• Causing the vein to collapse around the laser fiber or RF catheter
• Preventing pain during the laser or RF treatment
• Protecting surrounding tissue from the heat of the treatment

5. Treatment

During VenaSeal, the vein specialist uses a dispenser attached to the catheter to deliver medical adhesive to the problem vein. They apply gentle pressure to the leg to help the vein seal.

For EVLA or RF ablation, the laser or RF catheter is activated. As the vein specialist slowly withdraws the fiber or catheter from the vein, heat energy is applied along the entire length of the vein. 

No stitches are needed for any of these procedures, but a small piece of gauze or a bandage may be applied to the incision or injection sites. 

Possible Risks of Varicose Vein Ablation

Varicose vein ablation is usually complication-free, with less than a 0.1% chance of developing an infection that will require antibiotics treatment. Your vein specialist takes all the precautions to minimize your risk. 

Less than 6% of people who undergo varicose vein ablation experience thrombophlebitis or inflammation of the treated vein. Thrombophlebitis can temporarily cause redness and pain in the area. It is often easily treated with ice and over-the-counter medicine such as ibuprofen.

Deep vein thrombosis is a very rare complication in which a blood clot forms deep in the leg. It is extremely atypical but possible for the blood clot to travel to the lungs and cause a blockage called a pulmonary embolism. 

Varicose Vein Ablation Recovery and Aftercare

You can return to most of your daily activities, including work, immediately after varicose vein ablation.

Physical Limitations and Possible Side Effects

For the first one to two weeks after treatment, your doctor will likely require you to avoid: 

• Air travel
• Heavy lifting
• Saunas, steam rooms, and other heat therapies
• Tub baths, swimming, and hot tubs
• Vigorous exercise

Mild to moderate pain and swelling are common after varicose vein ablation. Over-the-counter medicines are generally enough to ease the discomfort. Extensive bruising is a normal side effect and typically fades within the first few weeks. 

About one to four weeks after the treatment, you may experience a feeling of pulling or tightness in your leg. This is normal and will gradually cease over time. Other possible side effects include patches of numbness or skin discoloration. These are harmless but may take several months to disappear completely.

One month after varicose vein ablation, most symptoms will have probably decreased significantly — but you may still have minor swelling. Any remaining side effects will be gone three to six months after treatment.

At-Home Aftercare for Vein Ablation

You can do many things to speed up healing and minimize side effects. Taking care of yourself after varicose vein ablation includes:

• Avoiding prolonged periods of standing and sitting
• Elevating your legs whenever you sit down
• Walking and stretching two to three times a day
• Resting when tired and making sure you get enough sleep at night
• Wearing compression stockings 

Typical Results of Varicose Vein Ablation

After treatment, you may experience immediate relief from varicose vein symptoms such as achiness or heaviness in the legs. Most people also notice a significant reduction in the appearance of varicose veins within the first week. However, it may take up to a year for treated veins to completely disappear. 

The First Step Toward Vein Treatment

To discuss what happens during varicose vein ablation with an expert near you, schedule an appointment through My Vein Treatment’s vein specialist locator. A vein specialist can provide an accurate diagnosis, explain treatment options, and help you develop a plan to relieve symptoms and eliminate blemishes.