Varicose veins are large, unsightly, purple or blue, twisted, swollen veins on the legs that protrude from the surface of the skin. This is obviously an aesthetic issue that can impact both appearance of the legs and can have a significant impact upon the self-confidence for those with this condition.
Although many people want treatment for varicose veins for cosmetic reasons, they are not just a cosmetic problem. They are a component of venous disease with symptoms that include pain, discomfort, and swelling.
Radiofrequency (RF) ablation is a safe, minimally-invasive treatment for varicose veins developed in recent years. Our vein surgeons at South Texas Vein Institute perform RF ablation with precision and skill, along with a range of minimally-invasive varicose vein treatments.
How Do Varicose Veins Develop?
The circulatory system of the body is an amazing mechanism. The heart pumps oxygenated blood to the body through the arteries and the veins carry deoxygenated blood back to the heart. The valves of the veins, when functioning properly, open and close, allowing the blood to flow in one direction only.
However, the legs are subject to gravity and the walls of the leg veins are under tremendous pressure. When the valves become damaged or weakened, they allow the backward flow of blood, which pools in the veins, causing varicose veins and other disorders. This condition is known as venous insufficiency.
In the case of varicose veins, venous insufficiency can cause the veins to be become large, swollen, twisted, and protruding. The backward flow and pooling of blood in the veins increases pressure, which can cause more varicose veins to develop. If left untreated, vein disease can lead to health problems, including, pain, swelling, changes in the skin, and ulcers.
What Factors Contribute to Varicose Veins?
Varicose veins, spider veins, and reticular (blue) veins are a common problem in the U.S. According to the American Society for Aesthetic Plastic Surgery (ASAPS), 270,223 sclerotherapy procedures were performed in a recent year. (Sclerotherapy can be an effective, minimally invasive treatment for spider veins, reticular veins, and smaller varicose veins.)
As humans stand and walk upright, the leg veins are under more pressure with the force of gravity than the veins in other areas of the body. In addition to gravity, a number of factors may predispose a person to develop varicose veins, including:
- Heredity (passed on through the genes from parent to child)
- Job or occupation that involves prolonged standing or sitting (hairstylists, wait staff, factory workers, office workers)
- Use of birth control pills or post-menopausal hormone replacement
- High-heeled footwear and tight, restrictive clothing
- Sun exposure
- Sedentary lifestyle
What Is RF Ablation and How Is It Performed?
Ablation is the surgical removal of tissues of the body. Radiofrequency (RF) ablation is a minimally-invasive treatment for varicose veins that uses radiofrequency energy to heat, collapse, and seal off (ablate) the targeted blood vessel.
The surgeon maps the course of the vein with ultrasound then makes a small incision near the knee in the diseased vein. A thin catheter is inserted into the vein through the incision and threaded through the vein up to the groin.
Radiofrequency energy (electricity) is delivered in pulses, heating the collagen within the vein, causing it to contract and the walls of the vein to shrink and shut down. The process is repeated, treating the vein in segments as the catheter is gradually withdrawn back toward the incision at the knee.
When the diseased vein has been entirely ablated, blood flow reroutes through healthier adjacent veins automatically. This restores healthy circulation and reduces swelling in the area. The treated vein becomes scar tissue and the body absorbs it over time.
RF ablation is an excellent alternative to more invasive vein surgery. It can be used on the large veins in the leg and can be performed in an office setting. This treatment is generally covered by most health insurance providers with proof of medical necessity and a history of previous conservative treatments.
What Conservative Treatments are Recommended Before RF Ablation?
Most health insurance providers want to see a history of conservative treatments before coverage is approved for procedures to treat varicose veins, including RF ablation. At South Texas Vein Institute, we recommend conservative treatments for most of our patients, on their own or in combination with medical procedures.
Conservative treatments can show progression and help alleviate symptoms associated with varicose veins and venous insufficiency. Our vein surgeon may recommend any or a combination of the following:
- Compression stockings: Compression therapy is the primary conservative treatment for varicose veins. Wearing compression hose can improve blood flow, reduce symptoms, and helps slow progression of the disease.
- Weight loss: If you are overweight, shedding the excess pounds and maintaining a healthy weight typically improved the condition. Obesity is a contributing factor to varicose veins.
- Walking or other exercise for the legs: Walking is one of the best things you can do for your legs. Regular exercise for the legs tones the muscles and makes the calf muscle pump function more effectively to help return blood to the heart from the legs and feet.
- Elevating the legs: Putting your feet up can help counteract the effects of gravity. Elevate the legs above the hips as much as you can during the day. Sleep with your feet resting on a pillow to elevate your legs.
- Avoiding prolonged standing or sitting: If your occupation or other circumstances require you to stand or sit for long periods of time, take periodic breaks to improve blood flow and relieve pressure in the legs. Walk around for 5 minutes after every 45 minutes of sitting or standing.
What Is Recovery Like After an RF Ablation Procedure?
Patients experience less pain after RF ablation than with vein surgery. Recovery time with this procedure is typically minimal. As with any venous procedure, compression is a vital part of your aftercare to reduce postoperative tenderness and bruising and to help prevent blood clots. You will need to wear compression stockings for a week or more after the procedure, as determined by your doctor.
You should not lift any heavy objects, but normal activity is encouraged during your recovery. Within 3 to 7 days after your RF ablation procedure, you will have a follow-up reevaluation, at which time your vein doctor will use duplex ultrasound to ensure that the vein is closed and there is no evidence of clotting.
What Are the Advantages of RF Ablation over Vein Surgery?
RF ablation can be used to treat larger varicose veins as an excellent alternative to vein surgery. When performed properly, this minimally-invasive procedure can completely destroy the walls of the affected vein, forcing the body’s natural healing process to remove the vein.
Compared to invasive vein surgery, RF ablation has a number of advantages, including:
- In-office procedure
- Performed with local anesthesia
- Uses tiny incisions
- Less post-operative pain and bruising
- Faster recovery
- No chance of treated vein growing back again
- Less risk of infection
- Better cosmetic results
In a study entitled Endovascular Radiofrequency Ablation for Varicose Veins published by the National Institutes of Health (NIH), researchers found that, in comparison to vein surgery, RF ablation has:
- Quicker recovery due to decreased pain and lower incidence of minor complications
- Effectiveness comparable to surgery, as assessed by imaging-defined outcomes, including vein closure, blood flow, and reflux (venous insufficiency)
- Higher patient satisfaction
Is RF Ablation the Right Varicose Vein Treatment Option?
The best way to find out if radiofrequency ablation is the best treatment option for you is to consult with a doctor who has extensive experience in treating varicose veins. At South Texas Vein Institute, our practice is focused on minimally-invasive treatments of varicose veins, spider veins, and reticular (blue) veins. Our highly-trained vein surgeons personally perform every procedure, pay special attention to follow up, and personally manage all aspects of our patients’ vein care.
Medical technology for treatment of varicose veins has advanced considerably in recent years. Newer minimally-invasive treatments, such as RF ablation, can be performed on an out-patient basis under local anesthesia. These treatments consistently produce excellent medical and cosmetic results with a faster and easier recovery.
If you are ready to do something about the pain and discomfort of unsightly varicose veins, schedule a consultation in our state-of-the-art facility. After a discussion to gather information about your symptoms, medical history, previous vein treatments, and any medications you are taking, our surgeon will examine your veins using ultrasound. Dr. John G. Orfanos or Dr. Carlos Garcia-Cantu can tell you whether RF ablation is the most appropriate treatment option and individually tailor a vein treatment plan for you.