RADIOFREQUENCY – LASER – VEIN ADHESIVE PROCEDURE FOR TREATING VARICOSE VEINS

SOLUTIONS FOR VARICOSE VEINS ONLY THROUGH A PUNCTURE

The vascular surgery treatments offered at the Premier Med Healthcare, Training and Research Institute are safe, modern, state-of-the-art procedures that entail minimal risks and do not require anaesthesia. During the consultation our expert vascular surgeon, Ferenc Schmal MD recommends the best procedure tailored to your specific needs. You can spend the short convalescent period in a most comfortable environment and due to the fast recovery, you can resume your normal life very soon.

HOW IS RADIOFREQUENCY VARICOSE VEIN SURGERY PERFORMED?

The radiofrequency procedure is performed at Premier Med Healthcare, Training and Research Institute by a vascular surgeon. Besides the vascular surgeon, an anaesthesiologist will also be attending the procedure and an assistant will also be present helping the physician in the preparations and performing classical assistant tasks. The assistant will escort the patient into a dressing room, where he/she will be asked to change into treatment clothing. The treatment is performed in sterile conditions with sterile, single use devices.

Prior to the procedure, we mark the enlarged veins with a special marker while the patient is asked to assume an upright (standing) position. At the onset, we apply local anaesthesia on the affected limb, then at the knee we detect the enlarge vein under ultrasonic guidance and introduce a radiofrequency catheter into it through a fine needle. We control the exact placement of the catheter under ultrasonic guidance. Once it is properly placed, we inject a solution containing local anaesthesia all along the affected vein.

Apart from providing anaesthesia, the solution also protects surrounding tissue from heat damage during the procedure. Local anaesthesia is also performed under ultrasonic guidance. The anaesthesiologist also applies moderate sedation to release surgical stress and to complement anaesthesia. Once anaesthesia is applied, the radiofrequency catheter is gradually withdrawn, while the heat at the end of the catheter ablates the affected vein.

The success of the procedure can be well monitored in the ultrasonic image: one can see how the heat makes the blood in the vessel coagulate, the vessel walls shrink and the blood flow in the vein stops. After the procedure the patient spends a few hours in the recovery room. If neither the vascular surgeon nor the anaesthesiologist finds any complication after the procedure and the condition of the patient is satisfactory, then he or she may leave the health centre with an escort. Upon their departure, the patients will be given the documentation on the procedure and a prescription for an anticoagulation injection that is to be applied for 7-10 days in order to prevent postoperative thrombosis.

DETAILED INFORMATION ABOUT THE PROCEDURE

This information below aims to give you an overview of the vascular surgery solutions we offer to treat varicose veins, to provide answers for some of your questions and serves as a point of departure when you discuss the treatment with your physician. We do our best to give you an exhaustive overview during the consultation, but we always have time allocated to answering any further questions you may have, so we can clarify on any issues you may have about the procedure: we are Your team. The information below is not in lieu of medical advice provided by your physician. It may, however, help you ask questions in connection with the procedure.

WHY SHOULD YOU CHOOSE MODERN ENDOVENOUS RADIOFREQUENCY PROCEDURE?

The surgery is an ambulatory treatment, a painless, low-risk procedure with a short recovery period and outstanding cosmetic results. After the surgery, the varicose vein complaints will gradually disappear. If performed in time, the procedure prevents the formation of frequent phlebitis, chronic venous insufficiency and venous leg ulcers. In order to achieve the best results, it is important to resume to normal physical activities gradually, to wear the compression tights as instructed and to strictly observe the doctor’s recommendations as to changes in lifestyle. Without the procedure the varicose vein complaints will gradually become more severe, chronic venous insufficiency may develop with venous ulcer as its most serious complication. In such cases the procedure may not be performed or it has increased risks.

Traditional varicose vein surgery necessitates incisions at the inner ankle and the groin area and enlarged venules are also treated through incisions. The vein main trunk is removed by means of a probe introduced into the vein, which causes considerable tissue damage. Traditional surgery therefore causes heavy bleeding under the skin and postsurgical pain. There is a risk of infection of the surgical wounds. The surgical wounds and the sutures may make maintaining personal hygiene difficult.

As opposed to traditional surgeries, radiofrequency ablation is performed under local anaesthesia and involves minimum pain. There are scars left behind and the cosmetic results are superior. The occurrence of surgical complications is insignificant, and a few days after the procedure you can resume your fully active life.

According to international studies, the recurrence rate of varicose veins after radiofrequency procedure is smaller than or the same as in the case of traditional surgical solutions.

RADIOFREQUENCY PROCEDURE – POSTOPERATIVE CARE AT HOME

Patients do not need bedrest. Generally we recommend our patients to wear compression tights for 2 weeks following the procedure. On the week following the procedure our surgeon will perform a follow-up examination. Appointments are made in advance. Patients are advised to refrain from strenuous physical labour before the follow-up examination. They are expected to fully return to work 1-3 weeks after the procedure. 2 weeks after the treatment patients are allowed to do light sport activities. Precise instructions will be tailored to the individual needs of the patients.

FOR WHAT SYMPTOMS MUST YOU IMMEDIATELY CONSULT YOUR PHYSICIAN?

In the case of postoperative fever, sudden swelling of the limb, throbbing pain, pain in the chest or heavy breathing, please consult your physician immediately.

WHAT IS THE REASON FOR HEALTHCARE PROFESSIONALS PERFORMING PROCEDURES OTHER THAN ENDOVENOUS RADIOFREQUENCY SURGERY?

There has been a number of new surgical procedures recently in the field of vascular surgery. One of these is the radiofrequency endovenous procedure. In order to perform such procedures, health centres and hospitals need modern technical background and state-of-the-art devices, such as single-use catheters, which makes these procedures considerably more costly than traditional surgical solutions. Currently the expenses are not covered by social security.  Thus all costs are to be reimbursed by the patient. But if we take into consideration that recovery time and sick leave are significantly shorter, that pain is far less and the cosmetic results are far superior, then modern procedures appear to be the better choice.

WHAT ARE THE CONDITIONS OF THE PROCEDURE?

The procedure can only be performed, if the patient has sound deep venous circulation. This is verified by a preliminary duplex scan ultrasound examination. Patients will need lab test, ECG and medical examination results acquired not more than 2 weeks before their consultation with our anaesthesiologist. In some cases chest X-ray results acquired not more than 6 months before the procedure may be necessary.

If the patient is allergic to local anaesthesia, it cannot be performed. If the patient had a deep vein thrombosis, the procedure can only be performed if the deep vein circulation is satisfactory. In the case of severe post-thrombotic syndrome, the procedure is usually contraindicated. If the main vein trunk is extremely capacious, the procedure cannot be performed for technical reasons.

If the preoperative lab results show morbid changes or in the case of severe intercurrent diseases / coagulation disorders, known and severe diseases of the heart or the lungs the ERFA cannot be performed as an ambulatory treatment.

On the day before the procedure patients will have a light dinner and will not be allowed to drink any liquid after midnight.

Patient must not consume any food or liquid after midnight. In the case of non-compliance with these rules, the surgery cannot and will not be performed. Prior to the operation your surgeon will inform you about how to proceed with taking your regular medications.

POSSIBLE RISKS AND COMPLICATIONS OF THE RADIOFREQUENCY ABLATION

The radiofrequency ablation of varicose veins is a safe procedure. However, like every surgical procedure, radiofrequency ablation is also not without possible risks and complications. In rare cases bleeding may occur at the puncture site, which may be stopped with a compression bandage. Should the skin nerve along the treated vein be damaged, patients may experience temporary numbness, burning sensation or, in extremely rare cases, chronic sensation disorders in the inner ankle area. A palpable, sometimes sensitive fibre may form along the vein which can be eliminated through local treatment. Similarly, following the procedure, superficial phlebitis may occur in the venules, which will disappear without any particular treatment. In the recovery period a temporary swelling or tense sensation may occur on the operated limb.

VEIN ADHESIVE PROCEDURE FOR TREATING VARICOSE VEINS

The latest procedure entailing the least possible strain in the field of varicose vein treatment is VenaSeal that uses a proprietary medical adhesive delivered endovenously to close the vein. Introduced in the US in 2015, this method has been applied in Hungary since 2016.

After a thorough vascular examination the ambulatory procedure is performed in sterile conditions with a special, single-use device. Unlike other procedures, the adhesive technique requires no anaesthesia, no painful cuts that result in surgical stress, and no postoperative care of any kind.

During this new surgical procedure, the special, medical adhesive essentially closes the enlarged veins from the circulation. Upon contact with blood, the adhesive polymerizes into a solid, flexible material, which is not harmful to the body. Clinical studies have found that the adhesive is completely safe.

HOW IS VEIN ADHESIVE PROCEDURE FOR VARICOSE VEINS PERFORMED?

Prior to the procedure, we mark the enlarged veins with ultrasound, while the patient is asked to assume an upright (standing) position. In the operating theatre the affected extremity will be sterilely isolated. A puncture will be made in the enlarged vein on the lower leg or the knee area and 1-2 ml of local anaesthetic will be injected. Then the guidewire will be introduced. With the help of the guidewire the catheter is placed under ultrasonic guidance to the groin area. Then the adhesive will be gradually supplied through the catheter and the vein will be sealed.

After the procedure, patients can leave the bed immediately and can resume their normal activities without any restrictions or caveats. Patients can virtually immediately resume their work or sports activities, they do not need to wear compression tights. Also, the injection treatment to prevent the formation of thrombosis is unnecessary. The majority of the enlarged venules (if there are any) will withdraw within 10-12 weeks. If further treatment is necessary for aesthetic reasons, then sclerotherapy will be applied at the follow-up examination.

The procedure brings results identical with those of other varicose vein treatments. In past years thousands of patients have received VenaSeal treatment all over the world benefitting from its main advantages: the entire process is painless and recovery time is reduced to virtually nothing. In 5 to 15% of the cases mild inflammation may occur which can be eliminated through compression or local anti-inflammatory treatment.

THE ADVANTAGES OF ENDOVENOUS VENASEAL ADHESIVE TREATMENT

  • ambulatory treatment in a single session; no hospital stay necessary
  • no need for spinal or general anaesthesia
  • minimal postoperative bleeding in the tissues
  • almost zero recovery time
  • patients can get back to work immediately, no lengthy sick leave
  •  outstanding cosmetic results

 

The single-use devices used during the procedure are costly and are presently not funded by the state (National Health Insurance Fund – NEAK), therefore patients will be charged the expense of the treatment. However, the above advantages will amply compensate for the price, and the fast recovery, the painless procedure and the outstanding cosmetic results will all tip the balance in favour of the VenaSeal treatment.

LASER THERAPY FOR VARICOSE VEINS

Similarly to the radiofrequency surgery, the laser therapy is one of the so-called endovenous surgical procedures. The laser treatment is applicable with all patients who meet the requirements of the radiofrequency surgery.

If the dilation of the varicose veins is between 12 mm and 20 mm, only the laser therapy can be applied as this technique allows the destruction of vessel walls by using greater and controllable heat energy.

HOW IS THE LASER THERAPY FOR VARICOSE VEINS PERFORMED?

Laser therapy is performed under local anaesthesia or in moderate sedation by positioning a glass fibre catheter under ultrasonic guidance into the dilated vein up to the groin area where the dilated vein joins the deep venous system.  After this, by gradually withdrawing the catheter we seal off the vein with the help of the laser light energy that transforms in the vein into heat. Consequently, the treatment method, the postoperative care, the threats and possible complications are identical with those described in the radiofrequency procedure information booklet.

In our Health Centre we use the Biolitec Leonardo Dual 100 which is the most state-of-the-art laser generating device in Hungary today. The single use catheter operates with double-ring technology and emits circular laser light which further increases the efficiency of the device.

Prior to the treatment a vascular surgeon will be examining the affected veins and will determine the most adequate treatment for the patient.

POSTOPERATIVE CARE AT HOME

Patients are expected to fully return to work 2-3 days following the procedure. For a week, once a day patients will receive an anticoagulation injection, and for they are required to wear compression tights for 2 weeks following the procedure. 2 weeks after the treatment patients are allowed to do light sport activities.

CONSULT WITH OUR EXPERTS SO WE CAN HELP YOU!

Choose us and minimize the waiting time for treatment. We can give you an appointment at the earliest convenience.

our physicians

DR. SCHMAL FERENC

Vascular surgeon specialist

PRICES OF VARICOSE VEIN TREATMENT: