Description of the procedure
Contemporary laser and radiofrequency vein ablation has been applied in the world since year 2000; up until now, more than 100 000 such procedures have been performed. It is characterized by rapidity and precision with minimal number of possible complications.
The procedure takes for about an hour; postoperatively without surgical cuts, without scars, hematoma and swelling, completely without pain. Half an hour after the procedure, the patient can get up and go home; tomorrow, he is ready for all regular activities.
Also, extraordinary aesthetic effect of this surgery, as well as complete lack of postoperative pain, are very significant.
Risk factors are: positive family history of disease (hereditary), obesity, flat feet, sex – female hormones, multiple pregnancies, oral contraceptives, ‘standing’ and ‘sedentary’ professions; age.
Our patients are people who cannot allow themselves a sick leave – they want and have to work the next day, because nowadays, a job is a privilege.
Equally, those who do not want to suffer pain.
Also, elders and ill people who have elevated anesthesiological risk.
Generally speaking, we have many patients, because people nowadays are well informed and know exactly what they want.
Before the surgery, it is necessary to perform laboratory testing, make an EKG, prepare relevant medical documentation in case of some pre-existing diseases and disorders – results are to be brought for preoperative anesthesiological examination to Dr. Čandrlić. It is also necessary to fill in preoperative anesthesiological form, which you will be provided during the first examination.
During the anesthesiologic examination, the patient is provided with information on the type of anesthesia, regime of pre- and postoperative behavior – diet, hydration, activity, taking medication, etc. It is important to memorize that 6 hour prior to the procedure you are not allowed to eat anything; it is only allowed to drink water.
Three days prior to the procedure you should stop using painkillers and blood thinners from the group of nonsteroidal antirheumatics – acetylsalicylic acid (Aspirin, Andol,…). You must warn your anesthesiologist about the possible anticoagulant therapy and therapies of other sorts.
For the sake of safety, everything that is necessary concerning the preoperative preparation, surgical procedure, and postoperative course will be consolidated during the final arrangement for the surgical procedure – personally or over the telephone.
Immediately before the surgery, in his suite, the patient changes into our one-time use clothing; takes premedication – for the sake of relaxation and against anxiety. During the short ultrasound check-up, the vein and puncture spot (needle entrance) are marked with a felt pen.
Course of the procedure
The diseased vein is found using the ultrasound; through a small puncture opening in the skin, a small probe is lead through towards the varicose vein’s confluence – usually in the groin or knee cave. Along the vein, a saline with the local anesthetic is infiltrated using a needle, which served to protect surrounding tissue from high temperature radiated by the laser probe. After the check-up of the position of the probe, we start the machine, radiofrequent/laser energy with high temperature heats the vein wall, so it constricts and closes itself. Blood flow stops through the vein, and blood is redirected into the healthy veins which have the capacity to accept it; the treated vein stays in its place, it is not extracted, and, over time, it scars down.
At the end of the procedure, while patient is still on the operating table, he is dressed up with previously prepared, custom-made elastic compressive stockings.
Thermically processed vein immediately retreats; usually, a hematoma (bruising) and a passing induration (local swelling) remain along the treated vein, which disappears during the next two weeks – a period of wearing a compress.
At the spot of the probe entrance, there is a small puncture wound that heals in a couple of days.
Visible varicosities and widening disappear immediately after the intervention; 2-3 months later, the treated vein is not visible anymore, even at the ultrasound examination.
At the end of the surgical procedure, patient is dressed up with a custom-made compressive stocking that will be worn for the next two weeks – the first week continuously, for 24 hours, the second week only during the day. An hour after the procedure, the patient is escorted home.
Precautions and limitations
Endovenous techniques are indicated with patients who have insufficiency (valve weakening) in superficial vein system. It is contraindicated with fresh thrombosis in superficial vein and acute thrombophlebitis.
Side effects and complications
With radiofrequency treatments pain, pricking, or tightening – are completely absent.
Complications are possible, but very rarely; heat damage to the surrounding tissue – skin, fat tissue, nerves, hyperpigmentation – dark coloured skin of that area; sometimes phlebitis – vein inflammation or hematoma.
But, with procedure carefully and correctly performed by a reliable and skilled surgeon – complications are almost minor.
Package does not include: first indicative surgeon’s examination, vein color Doppler, blood test results, ECG, preoperative examinations by other specialized doctors due to comorbidity (pre-existing personal conditions, such as: diabetes, asthma, heart, high blood pressure, lungs, thyroid gland, allergies, etc.). Also, it does not include price for additional overnight stay (if necessary), expenses made prior to admittance into Polyclinic Lege Artis, telephone expenses, customary therapy.