Venous Ablation (Radio Frequency)

Venous ablation is a minimally invasive technique using intense thermal energy to irreversibly destroy an incompetent or diseased vein. This means the vein is:

• Damaged valve causing venous insufficiency
• Damaged vein becomes tortuous (rope like)
• Pooling of blood due to damages valve

A catheter with heat is inserted into the targeted vein and closes off the vein. The vein is closed off, but not removed.

Venous ablation is indicated in patients with symptoms of venous disease with reflux.

• Dilated, engorged, or tortuous veins (varicose veins)
• Skin discoloration
• Burning or itching sensation in the legs or feet or around the veins
• Swelling in the legs, ankles, or feet (edema)
• Heavy feeling or weakness of the legs
• Cramping or throbbing in the lower legs
• Skin ulcers
• Leg pain, especially after sitting or standing for a long period of time.
• Spider veins

A venous Doppler ultrasound is used to confirm the presence of venous obstruction, reflux, valvular incompetence, or clot formation.

Patients who do not qualify for venous ablation include patients with:

• Thrombus (blood clots) in the affected vein
• Infection in the vein (phlebitis)
• A combination of infection and clot known as thromboembolism.
• Pregnancy

The goal of venous ablation is to treat and reduce the symptoms and signs of venous disease.

Venous ablation is also useful in preventing the risk of complications from venous disease (blood clot formation).

Before the procedure:

This procedure is done here in our clinic. Arrive at the clinic at the time of your appointment.

You may eat and drink before and after the procedure. This procedure is not effecting by eating.

This procedure does not require any alteration in medications, so take your morning medications as prescribed.

The procedure lasts about 1 hour.

During the procedure:

The procedure will be carried out in our clinic in our procedure room.

During the procedure you will lay on a table positioned on your back.

Under ultrasound guidance, the exact location of the vein will be determined.

A guide wire is inserted through a small opening in the skin into the targeted vein.

Once the guide wire is in, an introducer sheath is passed over the guide wire. The guide wire can then be removed. Under ultrasound guidance, the catheter is passed through the sheath and is advanced up the vein until it reaches 2cms below a junction called the saphenofemoral junction.

Under sterile precautions, a local anesthetic along with sodium bicarbonate will be injected into the tissue along the length of the vein to ensure that you do not feel any heat from the catheter. This compress the vein from two sides and also separates the vein from other structures including nerves.

After the catheter is in place, the tip of this will send out a radiofrequency which is converted into heat that reaches 120oC. When the catheter is slowly withdrawn, the heat causes the vein to collapse and close off. Once the vein is closed off, blood is re-routed into other healthy veins.

After the procedure:

While you are on the table, an ultrasound will be done over the ablated vessel to confirm that the vessel is collapsed as well as an absence of blood flow in that vein.

Following the procedure, a bandage will be placed over the insertion site. A compression bandage will be wrapped around the entire length of the leg and should be worn for 2-3 days.

A compression bandage is important because it helps prevent bruising and tenderness as well as reduces the risk of blood clot formation and dislodgment. A compression stocking is required to be worn for up to 4 weeks.

You are encouraged to walk for at least 30 minutes a day after the procedure to prevent deep vein thrombosis.

Avoid heavy or strenuous exercise for a few days.

Avoid prolonged sitting or standing.

Wear compression stockings for up to 2 weeks.

An ultrasound follow up is required 3 days after the procedure to rule out any deep vein thrombosis (clot formation).

After 4 weeks of the procedure, an ultrasound follow up is required to ensure the complete closure of the vein and no reflux.

Venous ablation is generally a safe procedure, but with any surgical procedure it carries a risk.

If they occur are minor and temporary.

Complications include:

• Bruising
• Pain
• Infection
• Skin burn
• Blood clot formation
• Perforation of vessel
• Nerve irritation or damage

The benefits of venous ablation include:

• Relief of symptoms
• Outpatient procedure
• Well tolerated procedure
• High success rate
• Less invasive, less pain, tenderness, and few complications compared to surgical venous procedures
• Does not require general anesthesia
• Quick healing time
• Can return to normal daily activities within 1-2 days.
• Good cosmetic results
• Greater efficacy compared to venous surgical procedures with a positive prognosis of 10 years.