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Venous Disease: Endovenous Thermal Ablation

What is endovenous thermal ablation (laser therapy) for venous disease?

Endovenous thermal ablation, also called laser therapy, is a newer technique that uses a laser or high-frequency radio waves to create intense local heat in the varicose vein or incompetent vein.

Heat is directed through a catheter to close up the targeted vessel. This treatment closes off the problem veins but leaves them in place so there is minimal bleeding and bruising.

Compared with ligation and stripping, many patients find that endovenous thermal ablation results in less pain and a faster return to normal activities, with similar cosmetic results.

Why is this procedure performed? Why do I need this procedure?

The goals of treatment are to reduce symptoms and reduce the risk of complications from venous disease, including blood clots.

Patients who have large, symptomatic varicose veins and those with incompetent saphenous veins are candidates for this procedure. This procedure is essentially taking the place of “vein stripping.”

Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.

Where is the procedure performed and who performs this procedure?

This procedure is performed in the hospital surgical suite by a vascular surgeon.

What are the risks and potential complications of the procedure?

Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you. This is generally a very safe procedure. However, as with any surgical procedure, there are risks. Complications after endovenous thermal ablation may include bruising along the site of ablation, pain along the site of ablation, the development of a blood clot in the veins in the treated leg, and irritation of the nerves that run along with the treated veins.

Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.

How do I find out if I am a candidate for this procedure?

To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 44508.

How do I prepare for the procedure?

A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the procedure. You may need to discontinue certain medications before the procedure. Your healthcare team will provide specific instructions to help you prepare for the procedure.

What happens during the procedure?

You will receive a sedative and a regional anesthesia, or you may receive general anesthesia. Using an ultrasound to identify the location, your surgeon will insert a catheter into the vein to be treated. This is typically done just below the knee, but can occasionally be done at the level of the ankle. Using ultrasound, the surgeon will inject a solution of salt water and anesthetic agent along the length of the vein to be treated. Following this, either laser or radiofrequency ablation will be performed.

How long does the procedure last?

The procedure itself generally takes two to three hours. This procedure is typically performed in the outpatient setting, and you can expect to be discharged home several hours after the procedure is complete. Full recovery will take approximately one to two weeks.

What happens after the procedure?

Your surgeon will give you specific instructions you need to follow after the surgery until your incision heals adequately. Typically, patients should elevate the treated limb when not moving, keep the incisions clean and dry, avoid swimming or hot tubs and wear compression hose.

Compared with ligation and stripping, many patients find that endovenous thermal ablation results in less pain and a faster return to normal activities, with similar cosmetic results.

Are there any side effects of the treatment?

As with any surgical procedure, you will feel somewhat tired for a few weeks. In addition, you can experience pain and bruising along the site of the ablation. Rarely, you may experience some numbness or tingling along the shin. These typically resolve over a couple of weeks.

As with any surgical procedure, you will feel somewhat tired for a few weeks. In addition, you can experience pain and bruising along the site of the ablation. Rarely, you may experience some numbness or tingling along the shin. These typically resolve over a couple of weeks.

How do I gauge the results of the procedure?

Your doctor will discuss the results of the procedure with you, but outcomes are generally good.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.

Cleveland Clinic Heart and Vascular Institute Vascular Medicine Specialists and Surgeons

Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart and Vascular Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:

Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.

Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.

IVC Filter Retrieval Clinic - to make an appointment, call Vascular Medicine at 216.444.4420. Ask for Dr. Bartholomew in the Filter Retrieval Clinic. Your appointment will include a consultation with Dr. Bartholomew and the physicians who will perform the IVC filter retrieval procedure.

You may also use our MyConsult second opinion consultation using the Internet.

The Heart and Vascular Institute also has specialized centers and clinics to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

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Reviewed: 02/16