Endovenous Laser Ablation
Endovenous Radiofrequency Ablation, also known as RFA, is a minimally invasive alternative to the traditional ligation and stripping treatment of varicose veins. Varicose veins is a common medical condition involving diseased veins, usually in the leg.
As blood pools in the legs, the walls of the veins distend, until the veins appear raised and twisted under the skin. For some individuals, varicose veins present only a cosmetic problem. If the condition worsens, however, varicose veins can become painful and even dangerous and medical intervention may become necessary.
Reasons for RFA
Varicose veins result from weakened valves in the veins which permit the blood to flow backward instead of back to the heart. This back flow is called venous reflux. Venous reflux results in pooling of the blood in the legs, causing a variety of symptoms. These symptoms may include:
- Unsightly swelling and distension along the affected veins
- Pain which becomes more severe with sitting or standing
- A sensation of heaviness in the legs
- Bleeding, discoloration and ulceration along the vein’s path
Patients with small spider veins may not be candidates for RFA alone and may require sclerotherapy as well.
Benefits of RFA
RFA is a relatively new technique for treating varicose veins. It is minimally invasive, using radiofrequency energy to heat damaged veins and seal them shut. RFA may be preferable to traditional surgery which involved ligation and stripping of veins. RFA involves only a short, outpatient procedure with no general anesthesia and offers the following benefits:
- Successful removal of damaged veins
- Little pain or discomfort
- Very short recovery period
- Immediate relief from symptoms
- Small single incision with no suturing or scarring
The RFA Procedure
During the RFA procedure, the skin is numbed with local anesthesia, and a radiofrequency catheter is inserted into the skin and guided to the saphenous vein through ultrasound imaging. The saphenous vein is the large superficial vein carrying blood from the lower body back to the heart. Once the RF catheter is inserted, the vein is surrounded by a small amount of liquid and exposed to the RF energy. The RF energy causes the vein to be sealed off. The whole procedure usually takes less than an hour to perform. Blood flow may actually be improved by EVLA since the presence of the damaged vein is likely to have made the other veins work harder than usual.
Risks of RFA
While RFA is considered to be a very safe procedure with a low incidence of complications, there are certain risks associated with this procedure. Some of these risks may include:
- Deep vein thrombosis
- Nerve damage
- Burns to the skin
Recovery from RFA
After the EVLA procedure, patients are able to return home and resume normal activities the very next day. They are cautioned to avoid strenuous activity for a few weeks. While some pain is to be expected after EVLA, such pain is usually mild and short-lived, responding well to over-the-counter pain medications. Compression stockings should be worn for about a week after the procedure to lessen swelling, bruising and discomfort.
During and after recovery, patients are encouraged to live a healthy and active lifestyle in order to maintain the positive results and to prevent vascular damage in the future.