Frequently Asked Questions
What You Should Know
Before undergoing any medical treatment, you should have a clear understanding of the problem, the treatment, and the expected outcome. Dr. Regan from Vein Services at Wake Forest Baptist Health performs an extensive evaluation that includes a history, a physical exam, and a detailed venous ultrasound exam.
This allows him to accurately diagnose the source of your varicose veins and plan the best treatment. A great deal of time is spent with each patient to assure not only the highest quality of care, but also to make the patient an informed consumer.
What causes varicose veins?
Varicose veins are caused by malfunctioning valves that allow blood to pool in the veins of the legs. The great saphenous vein is the most common culprit. This vein may not be visible; however, the high pressure in this vein will cause normally small tributary veins under the skin to bulge. The characteristic symptoms then result. To effectively treat the visible, bulging veins, the underlying cause must be treated. This is usually accomplished with thermal ablation of the great saphenous vein.
In women, varicose veins may be caused by refluxing pelvic veins especially after multiple pregnancies. This condition may be associated with pelvic pain and heaviness, and is then called pelvic congestion syndrome. Pelvic congestion syndrome and associated varicose veins are readily treated with minimally invasive techniques.
What is endovenous thermal ablation?
A laser fiber or radiofrequency catheter is placed in the vein. The device heats and damages the wall of the vein. This causes the vein to permanently close.
How does losing the saphenous vein affect me?
When the abnormal vein is eliminated, the high pressure which has caused the visible varicose veins is eliminated. Venous drainage is then routed through more efficient, normal channels.
What happens if I need bypass surgery?
The saphenous vein is not the preferred conduit for bypass grafts. Arteries in the arms and chest wall are now most commonly used. Other veins are available, if needed. Also, the abnormal saphenous vein is usually not suitable for a bypass graft even if present.
How long does the procedure take?
Laser ablation typically takes1hour or less. The procedure is often performed in association with ambulatory phlebectomy to remove the large varicosities. This may require an additional 30 to 40 minutes.
What is the recovery time and what can I expect since this is a minimally invasive procedure?
Patients are able to walk out of the office and return to work and other normal activities the next day. Strenuous activity should be avoided for about 2 weeks after the procedure. The procedure itself is painless. Most people develop some discomfort during the first week after the procedure. This is usually relatively mild and passes quickly. Patients are given a detailed set of instructions. Close adherence to these recommendations will greatly reduce the risk of any post-¬procedure discomfort.
Does endovenous thermal ablation work as well as traditional vein stripping?
Laser ablation is a far less invasive procedure which allows for a much faster recovery with much less post-procedure pain. Long term follow-up studies have shown that the risk of developing new varicose veins is actually significantly less with laser ablation than with vein stripping.
What are the potential complications?
Significant complications are extremely rare. These include skin bums, blood clots, and numbness and tingling in the leg.
Does insurance cover this treatment?
Most insurers now cover laser or radiofrequency ablation when medically indicated. The procedure is not covered for cosmetic treatment. It is usually necessary to show that the patient has failed conservative management. This will usually involve the use of compression stockings for 3 months without significant improvement. Our office will submit all necessary information to obtain insurance pre-certification prior to any procedure.