Laser ablation can be used in a wide variety of venous abnormalities to target and close abnormal veins and restore normal venous function to the legs. An ultrasound examination is performed prior to treatment to evaluate the sites of abnormal superficial venous reflux and to assure normal function within the deep venous system. A thorough ultrasound examination requires examination in both a supine (lying down) and upright position (or examination on a tilted stretcher if the patient cannot stand) and usually takes about an hour. If abnormal superficial venous reflux is found, treatment of the vessel can be performed with laser ablation to eliminate the abnormally functioning vessel.
The patient is prepped and draped in sterile fashion (like an operating room but in the clinic) and numbing medication (Lidocaine) is used at the site of laser entry. The laser fiber is placed into the abnormal vein with the use of a needle. The laser fiber tip is placed at the upper portion of the abnormally functioning vessel with ultrasound guidance and more numbing medication is placed around the vessel to be treated (the physician uses ultrasound to follow the course of the laser). The laser is then activated and is slowly pulled back along the course of the vessel to close the vessel and the laser is removed. A small incision (usually 2-3 mm) is made at the site of the laser insertion and is covered with a Steristrip at the end of the procedure; no sutures are required. Laser ablation is very effective, is minimally invasive, can be performed as an outpatient procedure under local anesthesia and has an outstanding long-term success rate. Down time is minimal and post procedure discomfort is mild. Laser treatment is generally less expensive than Radiofrequency treatment while offering the same or higher success rate. The modern lasers (we use the new 1470 nm laser) have a comfort level roughly equivalent to radiofrequency treatment. Both laser and radiofrequency treatments are less expensive in most centers than surgical vein stripping and ligation which may require anesthesia services and the use of a hospital operating room.