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Endovenous Laser Ablation for Varicose Veins

 

This minimally invasive treatment is an outpatient procedure performed using imaging guidance. After applying local anesthetic to the vein, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the vein and guides it up the greater saphenous vein in the thigh. Then laser or radiofrequency energy is applied to the inside of the vein. This heats the vein and seals the vein closed.

Reflux within the greater saphenous vein leads to pooling in the visible varicose veins below. By closing the greater saphenous vein, the twisted and varicosed branch veins, which are close to the skin, shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.

What to expect after Endovenous Laser Ablation:

 

Immediately After Surgery ~ Day 1

  • Your leg will be wrapped in a compression dressing that has an outer ace wrap and an inner gauze dressing.  If your wrap becomes too tight, you can remove the outer ace wrap and rewrap it.  It needs to be snug, but not so tight that it is uncomfortable.
  • You may have drainage on your compression wrap.  Small areas of drainage (quarter to egg-sized) are expected.  If you experience drainage or bleeding that soaks through your dressing in larger areas than expected, hold firm direct pressure of the area of bleeding and elevate your leg.  Call Medical Imaging (775) 782-1533 and let us know immediately. 
  • You will experience soreness/pain in the area of surgery.  Take you ibuprofen three times a day with meals and this will decrease the pain and inflammation in your leg.
  • You may experience swelling in your leg and/or ankle.  Remember to elevate your leg intermittently throughout the day. 
  • Walk for approximately 10 minutes every hour while you are awake.
  • Take it easy today.  Remember, no heavy lifting or aerobic activity. 
  •  Remember to take your antibiotic tonight at bedtime or as directed by your physician.

48 Hours After Surgery ~ Day 2

  • You may unwrap your compression dressing and shower.  Do not take hot showers.  Cool your legs after showering.  NO tub baths for 2 weeks.
  • If the inner gauze dressing adheres to the incision sites, moisten it with warm water to release the dressing. 
  • Your leg will have some degree (from slight to a lot) of bruising on your inner thigh or back of calf, depending on the location of the laser treatment.  You will also have bruising at the incision sites along the course of the varicose veins.
  • You may have some “strings’ at the incision sites.  These are not sutures; this is simply some dried skin tissue.  Do NOT pull at these “strings.” They will fall off on their own.
  • You may have some incision sites that continue to drain at this point.  Just cover these with band-aids until they are well healed.
  • You need to wear your compression hose at this point for the next 7 days, during the day. You do not need to wear them to bed at night.
  • You can maintain normal activity, but no strenuous exercise or heavy lifting for the remainder of the week.
  • Continue to elevate your leg to prevent swelling and take your ibuprofen as directed by your physician.

Week One:

  • The inside of your thigh or back of the calf, where the laser procedure was done, usually begins to feel tight like a rubber band being stretched.  This is normal and can last several weeks as the vein is being absorbed. 
  • The bruising will begin to fade away, however, bruising can last several weeks, depending on the severity.
  • Remember to continue taking your ibuprofen and wear your compression hose during the day.
  • The puncture incisions should be healing.  Watch for any reddened incision sites that continue to drain.  If the site looks infected, call the Medical Imaging Department (775) 782-1533, immediately. 
  • You will still have some discomfort and soreness in your leg during this week.   Continue to maintain your normal activity and walk or change position hourly.  You should not sit in one position for longer than 1 hour.  Do not travel in an airplane for 2 weeks after your procedure.

Week Two:

  • You will continue to heal and feel the soreness gradually subside.  The inside of your thigh or back of calf will still feel tight this week.
  • You will return for your 2-week post operative ultrasound so we can check your progress.
  • You may find it comfortable to wear compression hose this week, especially as you increase your activity and with prolonged standing or sitting.
  • You may discontinue your ibuprofen after the second week.
  • You can resume all activity after the second week, however, listen to your body for signs that you may need to sit down and rest.

Three Months:

  • Your bruising and soreness should be completely gone.
  • You should notice that any symptoms of venous insufficiency (swelling, aching, heaviness, painful legs, etc.) you were experiencing prior to surgery, are significantly better.
  • You will return for your 3-month post-operative ultrasound to check your progress.