In reading through online forums on varicose vein treatment, it becomes obvious that many people don’t actually understand the basics of how the most popular varicose vein treatments work! Further, the confusion is not limited to people who are seeking information about potential treatment but also includes many people who have already received varicose vein treatment.
Often times, patients actually believe their varicose vein was “REMOVED” when in fact it was not. It was actually ablated, not removed. They’ll say things like, “I had my varicose vein removed six months ago with sclerotherapy.” However, sclerotherapy is a type of ablation therapy varicose vein treatment that does NOT actually remove the varicose vein.
The vast majority of varicose vein treatment performed today involves ablation therapy without the varicose vein actually being removed. Ablation therapy involves destroying the problematic vein from within. The ablated vein can no longer receive blood and the ablated tissue is then left inside the body to be reabsorbed like any other scar tissue (damaged or dead tissue). The most popular types of ablation therapy varicose vein treatment include:
– Sclerotherapy (chemical ablation, foamed sclerotherapy)
– Laser treatment (EVLA, EVLT, EVT, ELT, ELVeS)
– Radiofrequency (RF, RFA Closure, FAST, VNUS Closure, VNUS RF)
In ablation varicose vein treatment, the ablation of the varicose vein is accomplished using three basic methods:
1. The varicose vein is ablated with some form of precisely delivered energy (thermal ablation).
This energy can include laser energy of various wavelengths. Many vein doctors are moving toward using laser based varicose vein treatments that use longer wavelengths that are are thought to be more gentle and cause less bruising around the treated vein. Ablation can also involve energy in the range of radio waves.
2. The varicose vein is ablated with chemicals.
Over the years, the type of chemical used during sclerotherapy has changed. In fact, even today, different vein doctors prefer different chemicals (sclerosants) so you may want to talk with your vein doctor before your varicose vein treatment about what he or she prefers and why. In general, the chemicals used during sclerotherapy are less toxic and care is given to picking a sclerosant that doesn’t burn or sting.
3. The varicose vein is ablated by physical means.
This is less common than applying focused energy or chemicals to ablate the varicose vein. However, the ClariVein system is one example where a very gentle mechanical ablation technique is used to destroy the inner wall of a varicose vein. This mechanical destruction is augmented with chemical ablation similar to sclerotherapy.
In all ablation varicose vein treatment, a thin catheter is inserted into the vein to be treated. At the end of this catheter, the source of ablation (chemical, energy, and or mechanical) is delivered inside the vein in a highly controlled and precise manner. The problematic vein (and vein valve or valves) is immediately sealed off from the circulating blood by the ablation.
It should be noted too that ablation therapy is also used in many other types of medical procedures where problematic tissue must be destroyed. For example, if a few cells in the heart are causing an arrhythmia (abnormal heart beat), a doctor may ablate (destroy) these few dysfunctional heart cells to restore a normal heartbeat. Here’s another common example. Endometrial ablation inside the uterus can be used in some cases to regulate a woman’s menstrual cycle. Also, targeted ablation can also be used to kill cancerous cells forming a small tumor.
All types of ablation varicose vein treatment have significant advantages over vein stripping surgery that was so commonly used in the past. There is no hospitalization. The ablation procedures are done in a varicose vein treatment clinic on an outpatient basis. General anesthesia is not required. The procedures usually take less than an hour, are relatively painless, and the patient is up and walking right away. In fact, they are sent home or even back to work the same day as the procedure! While there may be some discomfort, it is minimal for most patients, especially if they follow instructions. These instructions include walking, wearing compression hose during the day, and avoiding sunlight and hot water on the treated area.
All of these varicose vein ablation procedures start with a detailed analysis of the veins using duplex ultrasound, also known as doppler ultrasound. Like what you see on a topographic map, duplex ultrasound allows vein doctors to take a very detailed graphic relief look at the inside of your veins. This test reveals the 3D structure of your inner vein walls and your vein valves.
Additionally, duplex ultrasound allows the vein doctor to look at how your blood is flowing through your veins. Is it flowing normally (toward the heart) or abnormally (away from the heart). The latter is known as venous reflux and is the telltale sign of varicose vein disease. The duplex ultrasound will also show the speed of the flow of blood, if the blood is slowed or stagnant in some areas, and how bad the venous reflux is if you have this.
With all the data provided by the duplex ultrasound test, the vein doctor can determine if you actually need varicose vein treatment and what type of varicose vein treatment would be best. He or she can also use this test to very precisely map out, within millimeters, where the ablation therapy should begin and end! During the ablation procedure, your vein doctor will also use duplex ultrasound to guide the ablation catheter to the precise locations where ablation is needed. This is why you’ll see these ablation procedures referred to as “ultrasound guided.”
When being evaluated for potential ablation therapy, it is always important to work with a varicose vein treatment clinic, like Metro Vein Centers, that routinely performs a variety of ablation therapy techniques. Although these techniques are similar in some ways, there are important subtle differences too. Therefore, you’ll want a completely honest assessment of which ablation techniques are best and why. You do not want this opinion influenced by any limitation on the ablation techniques offered at that particular clinic.
You can get a free evaluation of your veins and a free initial consultation with a vein specialist at any of the Metro Vein Centers’ multi-state locations. You do not need a doctor’s referral. Simply give them a call to set up an appointment convenient to your schedule. Don’t delay either. Catching varicose veins early can reduce the amount of varicose vein treatment you will need to fix the problem.