36478 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated

Name of the Procedure:

Endovenous Ablation Therapy of Incompetent Vein, Extremity, Inclusive of All Imaging Guidance and Monitoring, Percutaneous, Laser; First Vein Treated

Summary

Endovenous ablation therapy is a minimally invasive procedure that uses laser energy to close off varicose or incompetent veins in the legs. By sealing these veins, blood is redirected to healthier veins, improving circulation.

Purpose

This procedure is used to treat varicose veins and chronic venous insufficiency. The goals are to alleviate symptoms like pain, swelling, and skin irritation and to improve the appearance of the affected leg.

Indications

• Visible varicose veins
• Leg pain or aching
• Swelling in the legs
• Skin changes or ulcers due to poor circulation
• Chronic venous insufficiency
• Failed conservative treatments (e.g., compression therapy)

Preparation

• Fasting may not be required.
• Patients might need to adjust certain medications.
• Pre-procedure consultations may include ultrasound imaging to map the veins.

Procedure Description

1. The patient is positioned, and the skin over the treatment area is cleaned and sterilized.
2. Local anesthesia is applied to numb the area.
3. A small incision is made, and a catheter is inserted into the vein under ultrasound guidance.
4. The laser fiber is threaded through the catheter to the vein.
5. Laser energy is delivered along the length of the vein, causing it to collapse and seal shut.
6. The catheter and laser fiber are removed, and the incision is dressed.

Duration

Typically, the procedure takes about 45 minutes to an hour for the first vein treated.

Setting

The procedure is usually performed in an outpatient clinic or a surgical center.

Personnel

• Vascular or general surgeon
• Nursing staff
• Ultrasound technician
• Anesthesiologist (if deeper sedation is required)

Risks and Complications

• Bruising or swelling
• Infection at the incision site
• Nerve injury
• Blood clots
• Skin burns
• Recurrence of varicose veins

Benefits

• Relief from pain, swelling, and other symptoms
• Improved leg appearance
• Minimally invasive with a quick recovery time
• High success rate

Recovery

• Patients can usually go home the same day.
• Compression stockings are worn for one to two weeks.
• Restriction on heavy lifting and strenuous activities for a few days.
• Follow-up appointments for monitoring are necessary.

Alternatives

• Conservative treatments like compression stockings
• Sclerotherapy (injection of a solution to close veins)
• Surgical vein stripping
• Pros: Non-invasive options may be less painful.
• Cons: Non-invasive options might be less effective for severe cases.

Patient Experience

Patients typically experience minimal discomfort during the procedure due to the local anesthesia. Some swelling and bruising are common post-procedure. Pain management includes over-the-counter pain relievers and wearing compression stockings. Most patients resume normal activities within a few days.