Endovenous Laser Therapy,
        Ambulatory Phlebectomy,
                     Perforator Ablation

Endovenous Laser Therapy

A laser fiber may be used instead of the radiofrequency catheter for the VNUS closure/radiofrequency ablation. The results are generally similar although there tends to be more discomfort and bruising.
 

Ambulatory phlebectomy

You may have varicose veins that are larger than the typical spider veins and thus not ideally treated with sclerotherapy. Under those circumstances, you may be best treated by actual removal of the visible veins. This procedure is performed in the office setting using sterile technique and a form of local anesthesia. Tiny puncture incisions are made directly over the marked veins which are then removed directly. The incisions are closed either with a single suture or with a steri-strip tape. We then place your stocking on your leg. You will be able to walk home. There is minimal discomfort after the procedure, and you should be able to resume normal activities within a day.

 

Perforator Ablation

Sometimes we identify short veins that reflux from the deep veins to the superficial veins, usually in the lower leg. These refluxing perforators can cause high pressure to develop in the superficial veins and can cause local varicosities and ulcers to develop. We can ‘heat seal’ these veins using a variation of the technique we use for radiofrequency ablation of the saphenous vein described above. Under sterile conditions we give local anesthesia and thread a special catheter into the perforator vein under ultrasound guidance. We then heat seal the perforator vein and remove the catheter. There is minimal discomfort and excellent success rate with this procedure.