A non-invasive therapy called endovenous ablation or vein ablation treats varicose veins in the lower extremities.

The word "varicose" refers to a vein that is unnaturally and permanently distended. Vein walls or vein valves near the skin can become damaged from natural stretching or weakening because of the pressure of the blood flowing through the veins. Varicose veins often appear through the skin on a person's legs as blue, bulging and twisted veins. In some cases, the veins may be raised or stand out on the surface of the skin. If they are left untreated, the varicosed veins can cause tiredness or heaviness in the legs. In severe cases, varicose veins can lead to swollen ankles and scaly dry skin.

A less severe variation of varicose veins looks similar to a spider or spider web and are referred to as “spider veins.” Tiny blood vessels near the skin's surface called venules may become permanently dilated because of the pressure of blood inside leg veins. 

Vein ablation is a minimally invasive technique that destroys varicose leg veins. The treatment sends bursts of radiofrequency or laser energy through a catheter inserted into the damaged vein. The resulting heat intentionally destroys vein wall tissue along the length of the vein, relieving the pain associated with varicose veins and improving the appearance of the legs. The procedure has a low risk of side effects.

Varicose Vein Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center.
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
• Please plan to leave any jewelry or valuables at home.
• Make sure to arrange for someone to drive you home after the procedure.

Preparation

• Please take your medications with the exception of anti-coagulants.
• You need to be at the hospital’s admitting area one hour before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
• The nurse will also ask you about allergies.
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
• The nurse or tech will clean and shave, as necessary, an area around the catheter’s point of entry.
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure typically takes one hour. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
• The leg being treated will be sterilized and covered with a surgical drape. A local anesthetic (usually xylocaine) will be administered to the site where the incision will be made, generally immediately above or below the knee. Let your doctor know if you have an allergy to anesthetics.
• A thin catheter is inserted into the sclerosed vein and advanced up the vein to the top of the leg. Heat energy, a sclerosing agent or laser energy is then deposited/applied as the catheter is slowly withdrawn down the vein and removed. This treatment heats and seals the vein closed. Because the vein has been numbed, you should feel no pain.
• Blocking a faulty vein does not adversely affect the venous circulation, because other veins assume responsibility for blood return back to the heart. The diseased vein shrinks and scars down after treatment.
• Throughout the procedure, the OIA interventional radiologist guides the catheter using an external ultrasound wand positioned directly outside on the surface of the leg.
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
• Once the procedure is over you will be transferred back to your room.

What to Expect After the Procedure

• A compression stocking must be worn after the procedure to help reduce bruising, tenderness and the slim possibility of forming blood clots.
• Normal activity can be immediately resumed, with the exception of lifting heavy objects or prolonged sitting (for instance a long plane or car trip).
• You should not remain inactive or spend too much time in bed during the recovery period since this increases the chance for clotting complications.
• Successfully ablated veins are unlikely to reopen and cause later problems.
• Most patients will be discharged about 2 hours after their procedure.
• You will be given written instructions and a phone number to call if you have any questions or concerns.
• One of the interventional nurses will do a follow-up call the next day after your discharge. Write down any questions you might have for them.
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
• One to four weeks after endovenous ablation, the OIA interventional radiologist will follow up using ultrasound to ensure that the procedure was successful at treating the problem with the veins in the leg. The main vein should be completely closed at this point. Minor additional procedures to treat associated veins may be necessary.

General Information

People tend to develop varicose veins:

• Between the ages of 30 and 70.
• During pregnancy—varicose veins developed during pregnancy generally disappear within a year after giving birth. However, multiple pregnancies may increase a woman's risk of developing varicose veins.
• If a close family member has a history of varicose veins.
• Other risk factors include obesity, smoking, leg injury or prolonged standing at work.

Symptoms of venous insufficiency and varicose veins:

• A change in the appearance of the skin on the calf or leg.
• The appearance of small clusters of veins on the leg.
• An ache or heavy feeling in the affected leg.
• A burning sensation in the affected leg.
• A restless feeling in the affected leg.
• Night cramps.

People with significant varicose veins may be at a slightly increased risk of deep vein thrombosis or DVT. DVT may cause unusual and sudden leg swelling which requires immediate medical attention.