Endovenous Laser Ablation Treatment for Chronic Venous Insufficiency

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Rahul Sood

Endovenous laser treatment infographic.

Chronic venous insufficiency (CVI) has become one of the most common venous diseases in Americans. Every year, as many as 2.5 million people suffer from the condition in the United States. With CVI continuing to become a problem for many people, more forms of treatment are emerging to treat the disease. One of these is endovenous laser ablation, a minimally invasive therapy.

So how does this method work in treating venous insufficiency? Doctors use laser energy to seal off the malfunctioning veins, promoting healthier circulation in the surrounding blood vessels. 

How Endovenous Laser Ablation Works for CVI

Endovenous laser ablation is a form of therapy that combines imaging techniques and heat energy to lessen venous reflux. Based on an ultrasound result, the doctor makes a small cut on the skin where they inject a local anesthetic to numb the affected area. The vein will receive heat stimulation, collapsing it and diverting blood flow to neighboring blood vessels.

Patients are asked to wear goggles to protect their eyes from the lasers. The doctor will also ensure that the treatment area is sterilized to avoid infection. The patient may feel a slight pain during the anesthetic injection since multiple shots are needed to fully numb the vein. The discomfort will quickly subside.

The process of closing the deep vein through heat application is typically pain-free. However, some people may find the burning smell from the lasers uncomfortable. The heat will shut off the blood vessel and force it to collapse. Over the next few weeks or months, the body will reabsorb the problem vein. 

The entire procedure takes anywhere from 30 to 60 minutes, depending on the size of the area. Once the procedure is finished, the affected area will be wrapped with a bandage by your doctor or any qualified specialist. 

The dressing will be replaced with a compression garment after the first day. These garments place a healthy amount of pressure on the area. Doctors may ask you to wear these for a few weeks to minimize venous disease recurrence. Unlike surgical treatments, you are encouraged to return to regular physical activity.

What to Do After Endovenous Laser Ablation Treatment

You may return to regular activities after endovenous laser therapy, except for those that involve prolonged sitting (plane rides and long car rides). Your doctor may ask you to do light exercises during your recovery period. Extensive bed rest may exacerbate any side effects. Of course, strenuous movements, like weightlifting, should be avoided for the first few weeks. 

During the first few days, it helps to take a 5 to 10 minute walk every few hours. The light routine should help your leg’s healing process. You can also return to light office work, but make it a habit to get up and walk around at least every hour. 

The first night after the procedure may become uncomfortable. The new pressure placed onto your veins might make you feel irritable, but a light 10-minute walk should help relax the legs. You may also take some painkillers, depending on the advice of your doctor. The most commonly prescribed ones are ibuprofen, naproxen, and acetaminophen. Aspirin should be avoided as it may cause complications. 

Swimming or other wet activities are not advisable when you wear compression garments.

Elevating your legs is also recommended during sitting and sleeping. You may use a small stool during sitting and pillows when lying down. 

Patients may also experience tightness along the treated area in the first week. This mild discomfort usually goes away without further complications. You may take painkillers to help relieve the pain if it interferes with your daily functioning. 

Common Side Effects After Endovenous Laser Ablation Treatment

Endovenous laser therapy is a generally safe procedure. But as with most medical operations, there are also side effects after the first few days. Before undergoing the procedure, it’s important to consult with your doctor to check for any possible conflicting conditions. You may also have a modified aftercare plan if you’re taking any medications or have an active venous ulcer. 

The steps to manage your side effects involve lifestyle modifications. Eating a healthier diet, using ice packs, and doing light exercise also help alleviate these side effects. If you experience adverse reactions after the procedure, such as nerve damage, burns, or blood clots, contact your doctor right away. In rare cases, patients may develop deep vein thrombosis (DVT). This condition requires urgent medical care, as it can lead to a pulmonary embolism.

Soreness

Although endovenous laser ablation is a minimally invasive procedure, it is normal for patients to feel light pain in the treatment area. The soreness comes from the incision and the pressure from the inserted catheter. These sensations typically subside after a few days have passed. 

You may also take painkillers to help decrease the amount of pain you feel. If you still experience persistent pain after a week, tell your doctor in your follow-up visits. They may prescribe more compression garments or ask you to take medication. 

Light Bleeding

Light bleeding in the treatment area is normal. You may also notice blood stains on the dressing and garment. These typically stop after a few days. It’s also important to wash the treatment area to avoid infection. Washing also helps prevent the dressing from sticking to the healed incision. If the bleeding becomes too much, contact your doctor for assistance. They will provide you with the steps to replace the bandage if necessary. 

Bruising

Bruising may happen in the surrounding areas. These can be lessened by wearing compression garments. In rare cases, some patients may develop large bruises due to nerve damage. The damage resolves after a few weeks. You may also apply ice packs to the area to encourage healing. 

Discoloration

Skin discoloration may also appear in the treatment area. These are common in all skin types and can take months to fade away. The discoloration may look like dark lines or red sports along the incision sites. You may also feel the collapsing vein when touching the discolored areas. As the body absorbs the vein, the discoloration also stops. 

Infection

Medical procedures that involve cutting through the skin always have a chance of infection. With proper aftercare, you will not need antibiotics for your wounds after treatment. The catheter used in the procedure is sterile. Still, there is a slight chance that you may experience infection symptoms after a session of endovenous laser ablation. 

Consult your doctor if you experience fever, pus, and other hallmarks of infection. Avoid self-medicating as this can increase the chances of antibiotic resistance. 

Other Outpatient Vein Treatments Available at Vein Center Doctor

Gloved hand holding an injection with another hand pressing a cotton to the portion of the leg that has been injected.

Although endovenous laser ablation can remove your problem veins, there are also other procedures that help resolve CVI, venous thrombosis, and other deep vein issues. If you choose to ignore the signs of a venous disorder, you may develop complications that can affect your daily functioning. 

Vein Center Doctor offers 4 treatment methods to get rid of vein issues without conventional surgery:

  • Sclerotherapy
  • VenaSeal
  • Venous Compression Therapy
  • RFA for Varicose Veins

The specialists at Vein Center Doctor can help you determine which treatment plan is best for your symptoms. The method will depend on your family and medical history, as well as your desired long-term outcomes.

Sclerotherapy

Sclerotherapy is a well-known technique for the treatment of patients with venous incompetence. It has been a popular alternative to surgery for vascular diseases in the past few years. This non-invasive procedure helps people who have prominent varicose and spider veins. Venous insufficiency patients will also feel relief after the sealant closes off the vein wall with valvular reflux.

Doctors inject a solution straight into the injured superficial veins, which seals up the blood vessel. The blood travels into the other veins, repairing the area’s normal blood circulation. Before the body automatically absorbs the incompetent vein, it gradually deteriorates.

Some doctors also use sclerotherapy to treat vein problems in the face and hands. However, the most common site is the legs. Some patients may experience skin irritation after the treatment, although these side effects resolve on their own within days. Brown specks may also appear on the skin in the first 3 months after treatment.

VenaSeal

VenaSeal is another noninvasive procedure used to treat venous problems. Like endovenous laser ablation, VenaSeal involves a catheter. The catheter serves as the passageway for an adhesive that seals off the vein wall. The procedure works for patients who experience advanced symptoms of CVI, like swelling, pain, or numbness in the legs. Patients who want to get rid of spider and primary varicose veins may also feel better after a session of VenaSeal. 

To begin the operation, the specialist numbs the treatment area with a local anesthetic. A small cut is made on the skin, which will serve as the opening for the catheter. The process is typically painless, although minimal discomfort may be felt as the adhesive passes through the catheter. Circulation is redirected to the healthy veins surrounding the sealed vein wall.

Recovery time is shorter compared to vascular vein surgery. Patients can return to regular physical activity right away. Doctors typically recommend that you return to normal routines to encourage proper circulation in the legs. But to avoid overexertion and inflammation, refrain from weightlifting and other strenuous exercises in the first two weeks.

Patients with more than one damaged vein may need multiple treatment sessions. The intervals depend on the doctor, although some patients may have multiple injection sites in one sitting. The schedule depends on the patient’s medical history since your doctor may want to observe potential side effects first.

You may notice slight bruising and skin discoloration after the first few days of treatment. These fade over time, although the duration varies per person. Ice packs may help reduce the appearance of bruises. 

Venous Compression Therapy

Compression therapy is used in tandem with other procedures to help restore healthy blood circulation in the legs. People who undergo procedures to remove primary varicose veins will usually wear compression garments during their recovery period. The garments are a special form of stockings that help add pressure to the area. Some specialists may also use air pumps, boots, and other tools. 

These compression instruments add padding to encourage circulation in the surrounding veins. After sclerotherapy, RFA, and VenaSeal, it may take time for circulation to properly divert into the healthier blood vessels. The garments help make the process faster, although some people may wear them for longer periods. Doctors may ask patients who had larger veins removed to wear garments for 6 months to 2 years, depending on the severity of the disease. 

The type of garments used depends on vein diameter and severity of the disease. Some garments may be tighter and longer than others. Your doctor may prescribe medical-grade stockings to encourage faster healing. 

This conservative therapy is complementary to other procedures. On their own, the garments only help prevent new varicose veins from forming. They may also help relieve pressure in the legs. Other methods are still advisable to remove the problem veins from the body.

In the first few days of compression therapy, you may experience some itching and discomfort. These normally go away after you have gotten used to wearing the garments. If you experience any adverse events after the procedure, contact your doctor right away.

RFA for Varicose Veins

There is a new form of venous insufficiency treatment known as radiofrequency ablation (RFA). RFA uses ultrasound guidance and electricity to seal problem veins. Like sclerotherapy and VenaSeal, RFA is non-invasive, and recovery time is typically faster. Most patients can return to their daily activities after a few hours of the procedure. 

Ultrasound guidance is used to map out the blood vessels in the affected area. The operation begins when your doctor numbs the area with anesthesia. A small incision is made on the skin to allow the catheter to enter the damaged vein. Thermal energy travels through the catheter to seal off the vein and redirect blood flow to the surrounding vessels. 

Varicose veins may take a few weeks to fade from the skin depending on how fast your body absorbs the collapsed vessels. Patients can return to work immediately after undergoing RFA treatment. Light bruising is normal in the first 2 weeks of recovery. 

Book a Consultation With Vein Center Doctor

Vein Center Doctor is one of the most reliable healthcare providers in New York and New Jersey. We’re committed to providing safe and effective treatments for patients with venous diseases. We believe that conservative therapy and varicose vein surgery aren’t the only ways to take care of patients.

Our treatment plans are compatible with those suffering from superficial thrombophlebitis, deep vein thrombosis, venous reflux disease, and other similar conditions. If you need a reliable partner for your varicose vein treatment, consult with us today so we can work to meet your desired clinical outcomes.

Rahul Sood

DO, R.PH

About Rahul Sood

Dr. Rahul Sood is a triple board-certified physician who specializes in cosmetic vein treatment, namely spider veins and varicose veins, as well as any accompanying issues related to venous insufficiency such as leg pain. He has carried out over 10,000 leg procedures during 10-plus year career and is highly regarded throughout Westchester County and New Jersey.

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