A healthy living blog from Marshfield Clinic

Varicose veins: Ablation or surgery?

Hiking in the forest during summer / Wellness/Varicose vein ablation / 931214076

Varicose veins or spider veins are on a spectrum of chronic vein diseases that affect up to 50 percent of individuals in their lifetime.

Chances are you may have been affected by varicose veins or spider veins. You are not alone; these are on a spectrum of chronic vein diseases that affect up to 50 percent of individuals in their lifetime.

Both are caused by high pressure in the veins called venous hypertension. High pressure causes the valves to not work properly and the veins to enlarge. Spider veins are smaller and less severe, while varicose veins are larger veins that measure three millimeters or greater.

Varicose veins can be painful and cause the following symptoms:

    • Aching.
    • Heavy sensation.
    • Itching.
    • Bleeding.
    • Swelling.

“In severe cases, chronic vein disease can cause wounds, chronic skin changes, or severe swelling,” said Dr. John Petronovich, Marshfield Clinic Health System general surgeon.

Initially, your doctor may recommend conservative treatments such as exercise, leg compression or elevating your legs. In more severe cases, your doctor may recommend other treatments. Your doctor will use an ultrasound to evaluate the size and function of your veins.

Surgical excision

Surgery is sometimes a necessary intervention to treat varicose veins.

A surgeon will typically perform this surgery in an operating room setting under general anesthesia. The surgeon will then make a small incision to remove the vein.

Recovery can vary for this procedure. Sometimes this is the only option to treat the veins.

Thermal ablation

Ablation is a procedure that is typically completed in an office procedure room where you can remain awake. During the procedure, your care team may give you light sedation and numb the area.

Your doctor will then insert an IV into the vein. This allows your doctor to pass a catheter and treat the vein using an ablation probe. The vein is left in place, but it will no longer function or cause symptoms.

“This treatment has been shown to have at least equal results to surgery in appropriately selected patients. These patients tolerate the procedure well, have minimal pain and go home to their normal activities shortly after the procedure,” said Petronovich.

Your doctor will request a routine follow up ultrasound after the procedure to ensure adequate closure of the veins and assess for any blood clots.

While ablation is an option for many, it is not an option for everyone. Both procedures also may require additional procedures to address all varicose veins and spider veins. Your doctor will help you decide what is most appropriate for you.

For more information about treating varicose veins, talk to your primary care doctor.

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