Endovenous Laser Ablation

Endovenous Laser Ablation does not require incisions or general anesthesia. In nearly all cases, this advanced treatment has replaced traditional vein stripping, a more invasive procedure. Endovenous Laser Ablation is less painful than traditional surgery and offers a faster recovery. Endovenous Laser Ablation is performed in the comfort of our offices by our highly experienced endovenous laser surgeons — among the most experienced on the West Coast. 

Radiofrequency (RF) Ablation

RF Ablation, just like Endovenous Laser Ablation, is a minimally invasive treatment that has replaced traditional vein stripping.  In this type of procedure, a small catheter is inserted into the vein through a small incision in the skin.  The catheter delivers pulsed radiofrequency energy to deliver even and uniform heat to the collagen in the vein walls.  As the catheter is removed, the heat causes the vein walls to close and seal.  Blood is diverted from the closed vein to healthy veins in your body.

Treatment in our office is performed in a comfortable setting with gentle sedation. Patient downtime following RF Ablation and Endovenous Laser Ablation is minimal and satisfaction is generally excellent.

Both forms endovenous thermal ablation – RF and laser – have been available now for over ten years. They have proven track records of being both safe and durable treatments for varicose veins.  There are distinct advantages and disadvantages to each form of therapy, and one or the other may be a better option for you (depending on your venous anatomy and treatment goals).

Lake Washington Vascular is pleased to be one of the few providers in the Pacific Northwest that can offer both forms of endothermal ablation to our patients. After evaluating your vascular lab study and examining your legs, your surgeon will recommend a treatment plan individualized to you. 

Surgery

Traditional surgical therapy, such as vein stripping, is unnecessary is most cases. Surgery with very small incisions (also called microphlebectomy) is a technique where larger veins or communicating veins from the muscle are removed through tiny incisions. These incisions, in our practice, have been reduced drastically in size (5 mm or less in length) due to the assistance of ultrasound guidance and specialized instruments. No stitches are required, so scarring is minimal. Sometimes microphlebectomy, especially for the communicating veins, will be used in conjunction with endovenous laser therapy to optimize your vein treatments.

Sclerotherapy

Sclerotherapy is a method of treating varicose veins and spider veins (telangectasias) under the skin. A substance called a sclerosing agent is injected with a tiny needle into the veins to cause inflammation and eventual obliteration of the blood vessel.

Echosclerotherapy

Echosclerotherapy is a technique that has been evolving over the past 10 years.  It utilizes ultrasound to guide sclerotherapy injections into larger varicose veins or veins too deep to see. These veins may be the cause of unsightly surface veins. Using ultrasound visualization technology allows your doctor to pinpoint and target the veins that need treatment, minimizing the amount of injections you need and maximizing their effectiveness.

How many treatments will I need?

Varicose and spider veins come in all sizes, shapes, and numbers. The number of treatments needed can be estimated at the time of your visit with your physician. Over time spider veins and varicose veins can recur or new ones may develop, and future treatments may be needed.

What are the common side effects?

• Itching. Mild itching experienced at the vein site and along its course may occur for up to a day after injection.
• Skin Hyperpigmentation. Approximately 50% of patients who undergo therapy notice a brownish skin pigment after the vessel is treated. In most patients, the veins become darker right after the procedure. The veins gradually and steadily fade over the next 12 to 15 months. Rarely, permanent brown staining may occur.
• Allergic Reaction. Rarely a patient may have an allergic reaction to sclerosing agent solutions. Let your physician know if you have any allergies prior to treatment. Allergic reaction may include hives, shortness of breath, or nausea.
• Pain. Occasionally patients may experience pain at the site of injection. After treatment, the injected vein may be tender to the touch along its course. This is temporary and usually resolved in three to six weeks. Acetaminophen or ibuprofen is usually all that is needed for pain after sclerotherapy.

What are other possible side effects?

• Tiny new blood vessels may develop at the site of previously injected veins. Transient swelling or hives may occur. Wound infections and breakdown of the skin are rare complications that may require treatment. 
• Scarring is unusual, but may occur. 
• Deep vein clots, which are very rate, can cause complications such as long-term swelling or clots traveling to the lungs.