Endovenous Ablation -  Sealing the Vein

Right GSV EVLA labeled

Endovenous Laser Ablation

How It Works

We will be sealing the vein with heat created by an FDA-approved laser. This vein closure forces the blood to go around the damaged vein to healthier veins, and helps to reduce swelling and pressure in your leg.

Day of Treatment

After we check you in for your appointment, we will have you change into our cloth shorts and increase your circulation through walking.  We will do a limited ultrasound to mark the vein to be treated and check for any blood clots. We will clean your leg and cover it with sterile linens. We will use cold spray and ultrasound guidance to place the small IV and laser fiber in the vein. A cold numbing medication “pillow” will be placed around the vein while heat treating. Some pressure is a normal feeling. Once treatment is complete, we will clean your leg and place dressings and your thigh high medical grade compression stockings on your leg. You will walk after the procedure to improve the circulation prior to leaving our office. The appointment is scheduled for 1.5 - 2 hours. You can return to work and normal daily activities directly directly after leaving our office.

What to Expect Post Procedure

You may see some bruising. The numbing medication will wear off over several hours, and the “swelling” sensation will fade as the fluid is absorbed. There is often superficial inflammation or “thrombophlebitis” that can occur where the vein is treated. Often patients experience pulling, aching, tightness, and a hard sensation of the closed vein under the surface. These symptoms are normal as the vein closes and may be experienced up to 10-14 days post procedure.  Some patients experience more severe painful thrombophlebitis and redness of the skin. These symptoms are less common, but patients find relief in icing the area of concern, elevating the leg, and taking anti-inflammatory medications such as Ibuprofen or Naproxen. Your legs may look and feel better right away, or more commonly it may take 1-2 weeks after the procedure to see improvement. Lumps or thickened regions in the treated areas will subside over time. Islands of numbness are uncommon but may occur due to inflammation of nerves from thrombophlebitis. Clots in the deep system or “Deep Vein Thrombosis (DVT)” is also uncommon (1/100 or 1/1000 patients). To reduce the risk of DVT, our physician keeps procedures short, uses a large amount of cold numbing medication around the treated area, stays a safe distance from the deep system, and encourages activity before and after your procedure.  Endovenous laser ablation with our latest generation TVS 1470 nm laser is 98-99% successful at closing the treated vein.

Aftercare

You can return to work and normal daily activities immediately. We recommend you wear your thigh high medical grade compression stockings for seven (7) days, DURING THE DAY, after your treatment. You can remove the stockings and dressings the evening after your procedure. Replace the stockings the next morning after showering, wearing them only during the day. Continuing to wear your stockings past the seven days may provide comfort,  especially while traveling (plane/car) or with prolonged sitting/standing at work.  Walking is the best thing you can do for your legs following the procedure.  Walking is essential to a timely and successful recovery. Walking and gentle exercise, 3-5 times a day, can help your circulation and healing process.  Sports and exercise routines can be continued, including running, walking, and elliptical training. We recommend avoiding excessive lifting or exercise that requires holding your breath for 2-3 weeks after your treatment to allow the treated vein to heal.  We will schedule a safety ultrasound within seven days from your procedure to ensure closure and scan for clots.