What is Varicose Vein Ablation?
This is where a small device is inserted into the vein that is causing your symptoms. Energy from radio waves (radiofrequency ablation) is used to heat the vein which closes it off and stops blood flowing through it.
Note: It may be wise to take some paracetamol 20 minutes prior to the procedure to prevent any discomfort.
During the Procedure
You will receive local anaesthetic via injections into your skin around the enlarged vein to numb the area. When you are numb, a needle is placed into the vein to be treated, in much the same way as an intravenous drip is inserted into a vein. A small catheter is then passed inside the enlarged vein, which delivers heat to the inside of the vein, blocking the blood flow to the vein so it shrinks and closes.
Benefits of the Procedure
You should expect your symptoms to reduce after the treatment and the risk of abnormal vein progression will be lower. You will also be at reduced risk of skin deterioration in the lower leg/s.
After the Procedure
Following the procedure, your leg will be placed in elastic compression bandaging. You can remove these bandages after 24 hours.
You will not be able to drive for a few days and you should have someone to take you home once you leave the clinic.
There is no prescribed time to be taken off work, and most people are able to return to work within a few days. Those who spend much time standing or have more arduous roles would benefit from further time away from work.
It is best to avoid air travel in the first 3 weeks (short haul) or six weeks (long haul) following this procedure.
Exercise after the procedure should include walking in the first week. Following this, a return to normal exercise can be undertaken gradually.
Risks
Whilst current treatments of varicose veins are safe and usually very well tolerated, there are always risks present when a surgical procedure is undertaken. However, the potential problems that can occur after these procedures are mostly not severe or they are infrequent.
The following are risks that could occur with the procedure. Whilst this list may seem extensive, please remember that in most cases no issues occur and where they do, they are usually minor.
Venous bleeding from the small surgical incision
This can occur when the compression bandaging is removed. Lying down, lifting the leg and pressing on the small incision will stop any bleeding.
Post-operative pain and bruising
This varies between patients. In most cases the pain decreases within 24-48 hours and is replaced by a dull ache which can last for 1–2 weeks. This is usually easily managed with painkillers such as ibuprofen and paracetamol.
Risk of wound infection (Less than 5 in 100)
Infections in these procedures are rare, as the incisions are small. Occasionally the treated vein may become inflamed, leading the surrounding area to become red, warm and tender, which can be misdiagnosed as infection. This inflammation, known as phlebitis, settles with anti-inflammatory medication such as ibuprofen.
Risk of failure of procedure (1 in 100)
For 1 in 100 people, the treated vein does not close, and further treatment is required.
Risk of recurrence (Less than 5 in 100 per year)
For 5 in 100 people per year, varicose veins will recur. People who have developed varicose veins are more susceptible to develop more varicose veins than people who have never been affected. These ‘recurrent’ veins are in most cases new veins that have developed.
Small risk of temporary numbness of area(s) on the leg
Small nerves that supply the skin of the legs can be affected by these treatments. Small areas of skin can become numb after the treatment, which may take a few months to recover.
Risk of permanent numbness on an area of the leg (1 in 100)
A small risk of deep venous thrombosis, and very small risk of pulmonary embolism
Clot forming in the deep veins is a very rare, but more serious complication of these procedures. If this does occur, it requires treatment with blood thinning agents for some months.
A small risk of brown staining
In rare cases, some blood may be trapped in an area of the treated vein. This can lead to staining of the skin if not managed. This can take many months to disappear and there may be some fine permanent discolouration.
A small number of new / increased thread veins
The treatment of bigger varicose veins can lead to fine thread veins in some cases becoming more noticeable, or to new thread veins forming.
Please note that for most people, none of these issues occur.