Varicose veins are unsightly and can be uncomfortable or even painful. They are caused by faulty valves that allow blood to pool or flow the wrong way in the vein and are most common in the legs. There are things you can do to prevent varicose and spider veins (smaller, visible veins that look like spiderwebs), but what can be done to treat them once they appear?
Let’s start from the beginning. The vein wall has three layers. The inner layer of the vein wall is known as the tunica intima, which is a thin lining of cells that prevents the blood from clotting. If this lining is destroyed, the blood will clot. An example of this is when a person gets a cut. The cut interrupts the intact tunica intima and the blood clots around that area in response. Over time, the skin heals, the lining grows back, and blood starts to flow again. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) use a similar principle to treat varicose veins.
Heat is generated from the radiofrequency catheter in RFA and the laser fiber in EVLA to burn this layer of layer of cells. When the layer is burnt, the vein cannot stay open, and it clots. Usually, the heat is sufficient to burn the middle layer of the vein known as tunica media.
What Is Radiofrequency Ablation?
Radiofrequency ablation (RFA or Venefit™) is a minimally invasive procedure that uses heat to treat varicose veins. The RFA catheter generates controlled heat at a target temperature of 120 degrees celsius. The heat from the catheter damages the vein walls, which closes the vein. Once the diseased vein is closed, blood is rerouted to healthy veins.
RFA is performed in a sterile, clinical setting under local anesthesia. You can go back to work on the same day.
During the procedure, Dr. Afzal inserts a catheter into the vein through a small incision. The heat from the radiofrequency closes the vein as the catheter is slowly pulled out.
After the procedure, it is common to experience some bruising or aching in the areas treated. Most patients have minimal discomfort and are able to continue with their daily activities. Less common side effects include local numbness from nerve damage and deep vein blood clots. In our practice, the incidence of serious side effects is less than 0.1 percent, which is much lower than the national average.
What Is EVLA?
EVLA stands for endovenous laser ablation. EVLA can use many wavelengths of light, ranging from 890 to 1470 nanometers (nm). Manufacturers claim that 1470 nm lasers cause less post-procedure discomfort, but in our experience, there is not much difference. In peer-reviewed published data, it is generally recognized that radiofrequency ablation (now marketed as the Venefit™ procedure) causes significantly less post-procedural discomfort than EVLA.
It is widely known that most free-standing clinics that perform EVLA sterilize and reuse their laser fibers up to 5 times. This practice reduces the effectiveness of the laser and increases the chances of infection. Re-sterilization in free-standing clinics is only as good as the person re-sterilizing the equipment. In addition, laser fibers are generally cheaper than RFA catheters and have a risk of breaking during the procedure, especially if proper care is not taken when re-sterilizing the laser fiber.
RFA catheters, on the other hand, are much sturdier, and if a clinic wants to re-sterilize the catheters, they have to send them to a company in the Minneapolis-St. Paul area called Vascular Solutions. Vascular Solutions has a free-standing, independent site that evaluates catheter quality and re-sterilizes at a cost that makes it an ideal option for green initiatives. At Afzal Clinics, we use RFA (Venefit™) as the main method of treatment along with sclerotherapy.
We do have the ability to perform EVLA, but we refuse to re-sterilize laser fibers. Afzal Clinics is a site for training on EVLA for Vascular Solutions and Covidien (the maker of Venefit™) in the Minneapolis-St. Paul area. It is a good idea to ask your provider if they re-sterilize laser fibers at their facilities or not.
Why Should You Choose Afzal Clinics?
Dr. Afzal is considered to be a regional expert in the treatment of vein disease. He also trains other doctors on the use of Covidien products, the manufacturer of the Venefit™ ablation catheters. If you are considering a radiofrequency ablation procedure, you can count on our team’s knowledge and experience.
Dr. Afzal prefers radiofrequency ablation over endovenous laser ablation because RFA leads to less patient discomfort and a quicker recovery period with comparable results.