ENDOVENOUS ABLATION OF THE SAPHENOUS VEINS LASER & RADIO-FREQUENCY ABLATION Pre-Operative PATIENT INSTRUCTIONS These instructions are to prepare you for the laser or radiofrequency ablation procedures to treat your vein problems. The saphenous veins were found to be abnormal due to valve dysfunction. These veins can be eliminated by the modern endovenous methods. The result is improved vein circulation in the leg, disappearance of the varicose veins, and relief of leg discomfort. You may resume most normal activities within two to four days without harm to yourself or your leg circulation. The following instructions are to prepare you for your procedure, and to help you understand better how to maximize your recovery. 1.Your procedure is to be performed in the Vein Center, and you may have liquids and solid foods up to 3 hours before your schedule operation. Do not consume beverages containing caffeine for 24 hours prior to your procedure. 2.Take your usual medications on the morning of your operation with a small sip of water. 3.Blood thinning medications are best avoided for several days prior to your procedure. Coumadin should be stopped at least 4 days prior, Aspirin 10 days prior, Plavix 7 days prior, Aggrenox 10 days prior, and Pletal 2 days prior. For some patients, especially if you have a blood clotting disorder, we may ask you to continue your medication. If you have questions, please ask our doctors about your medicines 4.Please bring your list of medicines with you to the Vein Center, and especially let us know if you have any medical allergies. We also wish to know if you are sensitive to medicines and might become nauseated or have other side effects.
5.Wear shorts or loose clothing to the Vein Center. Your leg will be wrapped in sterile dressings and ace bandages which will be somewhat bulky to wear under clothes. 6.You will be sedated during the procedure and will not be aware of most of the operation. Please bring someone with you to drive you home and to assure your safety. 7.The operation is performed in the Vein Center procedure rooms. You shall have monitors attached to record your blood pressure, pulse rate, and oxygen levels. Our doctors and trained staff shall be with you at all times. You will be sedated and you may have some amnesia about the operation. Toward the end of the procedure you may feel a few of the final sclerotherapy injections. There may also be a residual stinging and burning from these injections which will last several minutes. 8.Diluted local anesthesia is placed along the course of the treated veins so that you do not feel any discomfort. Your sedation will be adjusted to minimize your awareness during the time. 9.For most of the operations, a surgical incision is not required. Only small punctures are made to insert the ablation catheter and to remove ropy varicose veins. Sometimes a small incision is made at the groin level to ligate and divide a large saphenous vein. This protects you from a blood clot which might enter the deep vein from the treated and clotted saphenous vein. 10.Most ablation procedures are accompanied by either micro-phlebectomy or sclerotherapy or both in order to remove the unsightly and painful varicose veins or other visible veins in the leg. 11.Ultrasound images of the anatomy are necessary to perform the operation properly and safely. The room lights will be dimmed intermittently in order to see the ultrasound image clearly. 12.The laser fiber on the radiofrequency probe is inserted inside the saphenous vein and positioned to begin the ablation. Energy is delivered to the fiber or probe, which is slowly withdrawn through the vein. The heat gently destroys the lining of the vein. There is no pulling, stripping, or avulsion of branches.
13.The small wounds are closed with absorbable sutures or steri-strips, a sterile dressing is applied, and your leg is wrapped with elastic bandages. 14.You will be given a prescription for pain medication, but should take generic Ibuprofen 600mgs approximately every 12 hours for at least two to three weeks after the procedure. You may find during the second week that your thigh is somewhat tender due to the treated saphenous vein. Ibuprophen will help relieve that tenderness, and you may continue the medication as long as is needed. If you have any questions or problems, please call the office during working hours, or Dr. Maragh on his cell phone after hours. We prefer that you call rather than going to the hospital ER or your family physician, for we can usually help you more quickly.