Perforator Vein Ablation
The veins that connect the deep and superficial veins are called perforator veins. Like other veins in the body, they may weaken and become damaged. If their valves malfunction and allow a back flow of blood, called venous reflux, varicose veins may develop. Varicose veins appear as twisted ropes under the surface of the skin. They usually occur in the legs due to the fact that there they are working against gravity. While patients with varicose veins may be asymptomatic, at least initially, varicose veins may cause troubling symptoms, such as pain, swelling, itching or bleeding. Whether they cause medical symptoms of not, for many patients varicose veins may present daunting cosmetic issues. Patients with varicose veins should be thoroughly checked since the damaged veins may be an indication of circulatory problems elsewhere in the body.
Varicose perforator veins, like other varicose veins, may be treated by a number of procedures. Traditionally, varicose veins were treated by an invasive surgical process known as ligation and stripping. More recently, a procedure known as endovenous laser ablation, or EVLA, has been available. EVLA is a minimally invasive treatment found to be highly successful in treating most types of varicose veins. EVLA uses laser energy to seal off the affected vein with heat, relieving symptoms and improving appearance.
During the EVLA procedure, local anesthesia is injected to numb the area. A catheter with a laser probe attached to it is inserted through a tiny incision in the leg. The catheter is threaded through the vein, guided by ultrasound imaging. Once the laser probe is in proximity to the affected area, laser energy is focused on the vein for about about three minutes until the vein seals off. Circulation continues uninterrupted as the blood from the perforator vein is naturally redirected to another, healthier blood vessel.
There are many advantages to EVLA over more invasive surgical procedures. Since EVLA is performed outpatient, patients return home the same day and most can return to work the next day. The tiny incision does not require sutures and leaves almost no visible scarring. Pain after the procedure is minimal and recovery time is quite short. The patient can resume a normal routine, being careful to avoid strenuous exercise for about two weeks. Compression stockings are usually worn for about a week after the surgery.
As with any surgical procedure, even a minimally invasive one, there are some risks. Patients should be aware that, though rare, complications may include bleeding, clotting which may result in thrombophlebitis of deep vein thrombosis, thermal or nerve damage and allergic reaction to anesthesia. For the vast majority of patients, ablation of perforator veins is a relatively simple procedure with excellent results.