Endovenous Ablation: Laser and RF energy
Laser energy and radiofrequency energy sources are the modern tools of the venous surgeon which are the basis for remarkable transition away from traditional open surgical “Stripping and Ligation” and Trivex surgeries to the state of the art minimally invasive catheter based procedures. These new methods can now be done in the doctor’s office because the procedures are so precise there is no significant blood loss and no need “strip” out the vein. Instead of having to render the patient unconscious with a general anesthetic we now employ a local infiltration of very dilute lidocaine and epinephrine solution (Tumescent anesthesia) to remove any sensation in the area of the vein we are treating. This local anesthetic fluid also serves to insulates the surrounding tissue from the heat effects of the catheters and protect the surrounding tissue. The minute amount of epinephrine closes the small vessels surrounding the treated vein and prevents oozing and prolongs the effect of the lidocaine (xylocaine). Continuous duplex ultrasound surveillance during the procedure allows us to precisely determine the position of the catheters within the vein and monitor the results of the treatment to ensure optimal results and safety. Medicare and most PPO insurance companies approve endovenous ablation (laser or RF technology) to the Great Saphenous Vein and Small Saphenous Vein and under special circumstances to the Perforator veins in the ankles of patients who have venous ulcers.
These technologies require only a simple venipuncture to gain access to the vein and eliminate the need for unsightly groin and multiple leg incisions. This minimal access approach reduces the risk of hematoma, neuroma, seroma, painful incisions, unsightly scarring and nerve injury at the ankle and foot level. Most patients can resume normal activities the next day and return to work within 1 or 2 days instead of suffering weeks of painful recovery waiting for the swelling to go down and the wounds to heal. Because these technologies are so precise there is minimal discomfort during and after procedure and they result in little or no permanent scarring.
Risk and Complications: As with most medical procedures, endovenous radiofrequency and laser treatment involves potential risks and side effects. These include, but are not limited to pain/tenderness in the treated leg, bleeding and skin discoloration from bruising, nerve injury, and blood clots which may travel to the lung. To reduce these risks, we ask our patients to discuss their complete medical history with us and discuss this with their own physicians. This will allows us to determine if your medical history poses a unique risk for side effects or complications and gives us the information we need to formulate a strategy to better manage your condition.