June 5, 2017
Vein Stripping vs. Ablation Treatment for Varicose Veins
Do you think you might be suffering from varicose veins? You'll know by taking a look at the various symptoms of this disease. The most obvious signs of varicose veins are:
- Visibly bulging veins anywhere on the legs
- Veins have a dark blue, purplish color
- Dull, aching, and/or throbbing leg pain that gets worse as the day goes on
- Your legs are heavier and more tired after extended periods of standing
- Nighttime cramping or charlie horses
- Restlessness at night, just can't get your legs in a comfortable position
- Swelling around the ankles ("cankles")
- Skin discoloration around the shins with open ulcers
Fortunately, patients with chronic vein insufficiency (CVI) do have hope -- there are multiple treatment options available for varicose veins. How do you know which procedure is right for you? We will discuss the older method of vein stripping and compare it to modern, minimally invasive methods of varicose vein treatment.
Surgical vein stripping is generally performed in a hospital under anesthesia. During the procedure, the patient undergoes numerous incisions to pull the diseased vein out. The surgery usually leaves visible scars along the leg. Given how invasive the procedure is, patients oftentimes reported significant post-procedural pain and discomfort. The recovery for this older procedure was difficult. Most patients were out of work for potentially long periods of time, accompanied with many restrictions. The stripping method also had a high recurrence rate where the veins grew back, often more severe, years after the procedure.
- Performed in an OR requiring anesthesia
- Multiple large incisions requiring stitches
- Sometimes required inpatient hospital stay
- Higher risk of infection and bleeding
- Visible scars
- Significant recovery time/requires time off of work
- Post-operative bruising and pain
- High recurrence rate
- Veins can grow back
Thermal Ablation: RFA (radiofrequency) and EVLT (laser)
Thermal ablation relies on heat energy that is carefully delivered into the diseased vein to form scar tissue, which sufficiently closes off the bad vein. This method is done in a comfortable office setting with only local anesthesia or mild sedative for the affected leg. Patients are awake and they can listen to music or watch TV. Most are able to walk around immediately after the procedure. There are no major incisions, only a tiny nick in the skin where the catheter is inserted into the vein, which is then covered with a small bandage. The nick is so small that it does not require stitches and heals very quickly. There is generally no scarring. Most patients experience an easy recovery, returning to their jobs, social events, and normal daily activities immediately following the procedure, with only minimal restrictions. Thermal ablation has lower recurrence rate due to the minimally invasive nature of the procedures.
- Outpatient procedure -- patients return home immediately following the procedure
- No anesthesia
- No major incisions, just a tiny nick to the skin, so small that it does not require a stitch
- No blood loss
- Minimal if any scarring
- Immediately return to most regular activities
- Easy recovery
- Low recurrence rate
Radiofrequency Ablation (RFA) and Endovenous Laser Ablation Therapy (EVLT)
At the initial consultation, all the incompetent varicose veins are mapped out via ultrasound and the procedure details are discussed. On the procedure day, the interventional radiologist numbs the skin and then makes a small nick. A small catheter is inserted using direct ultrasound guidance. After numbing the entire length of the vein, the doctor delivers the RFA or EVLT energy to directly heat the diseased vein. Following the treatment, patients must wear a compression stocking for up to two weeks but can otherwise return to most routine activities right away. In fact, they are encouraged to exercise right away. During follow-up visits, the interventional radiologist uses a duplex ultrasound to ensure the vein is closed.
Still Not Sure If You Need Vein Treatment?
If you're not sure if you have varicose veins or if you would be a good candidate for treatment, sign up for a free vein screening! You'll learn more about the symptoms and causes of varicose veins, what treatment is like, and how best to find relief. We'll perform a limited ultrasound on your legs and educate you if treatment can help. Contact us if you have any questions.