Radiofrequency Ablation and Endovenous Laser Ablation are the two best modalities for treating the major superficial diseased veins in the legs. They each are very effective but may have different merits in differing clinical situations. The Nellestein Vein Institute is the only vein clinic within at least a 50-mile radius to offer both of these state-of-the-art modalities. The procedure is performed in the vein clinic and typically takes about 30 minutes. After a local anesthetic is utilized, a 1-2 millimeter puncture is made into the leg veins, usually just below the knee. A Radiofrequency Ablation or laser fiber is then inserted into the leg veins, utilizing ultrasound guidance, and placed in precisely the correct location. A very dilute anesthetic is then injected around the leg veins and indwelling fiber, creating a sleeve of anesthetic. Then an energy source is turned on in the tip of the catheter thus heating the inside of the vein and sealing it closed. The catheter is then slowly and precisely withdrawn, while heating, thus closing off the vein.
The patient is then placed in support stockings and goes home. No IV anesthetic is utilized. The patient can drive themselves to and from the appointment. Anti-inflammatory medications are typically all that are required for discomfort. The patient need not miss work and is told to wear the stockings for a few weeks afterward. These modalities are extremely effective vein solutions for the larger truncal veins. The tributary or varicose veins are better suited to microphlebectomy or ultrasound-guided foam sclerotherapy, which are often performed during the same visit at the RF/ELT. When these additional procedures are called for, the visit will typically be longer, on the order of 1-1.5 hours.