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What can I Expect During Endovenous Laser Ablation?

By Carol Kindle
Updated May 17, 2024
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Endovenous laser ablation is a medical procedure performed to remove varicose veins. This procedure is minimally invasive and involves the use of a laser that is threaded into the vein that needs to be removed. Heat from the laser causes the vein to collapse and eventually disappear.

Varicose veins develop in the legs when the valves inside the vessels no longer function. Instead of blood being pumped back to the heart, it pools in these veins and causes them to enlarge. Enlarged varicose veins can bulge under the skin and they may have an unsightly rippled appearance. Varicose veins may occasionally become painful, and patients may feel some fatigue and a need to rest the legs.

Patients may choose just to manage the discomfort caused by varicose veins with rest or medication, feeling standard surgical treatments are too invasive. Endovenous laser ablation is the least invasive surgical therapy and can be done on an outpatient basis. The procedure can take up to one hour to complete and the patient can typically begin walking immediately afterward.

To perform the endovenous laser ablation procedure, the physician or radiologist injects a local anesthetic into the varicose vein. A hollow needle is inserted into the lower end of the vein followed by a guidewire. The guidewire is threaded through the vein until it reaches the portion of the vein that needs treatment. Ultrasound of the vein is done simultaneously to confirm that the guidewire is in the proper location.

Once the guidewire is in place, a hollow catheter is inserted over the guidewire. The guidewire is removed and a laser fiber is threaded through the hollow catheter. When the laser fiber is in the appropriate location, the laser is activated and a red light is visible under the skin. The physician carefully begins to pull the laser through the vein toward the exit point on the skin. As the laser heats both inside walls of the vein and is pulled through the vein, the vein collapses behind it.

The treated varicose vein then closes and is no longer functional. Tissue from the vein is eventually reabsorbed by the body. Since varicose veins are usually superficial, the remaining veins in the leg should provide enough blood circulation.

Patients undergoing the endovenous laser ablation procedure may feel some pain from the injections and catheter insertion. Compression stockings are usually worn on the affected leg for approximately seven days. There may be some soreness or bruising in the area where the catheter was inserted. The recovery period is usually very short, and the patient should be able to return to normal activities within a few days.

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