Minimally Invasive Procedures for Varicose Veins

If varicose vein symptoms aren’t relieved by compression garments and other lifestyle changes, your NYU Langone doctor may recommend a minimally invasive procedure to eliminate the veins. These procedures are performed at our Vein Center using local anesthesia, and you can usually resume your usual activities the same day.

Thermal Ablation

At NYU Langone, our vein specialists typically perform procedures that involve applying heat to the damaged veins. There are several methods.

Radiofrequency Occlusion

Also known as the Venefit™ procedure, radiofrequency occlusion is a fast-healing treatment that uses electrical energy to deliver heat to varicose veins and destroy them.

To perform the procedure, the doctor makes a small incision below the knee. He or she then uses ultrasound—a technique that uses sound waves to create images of a vein—to guide a small, flexible tube into the damaged vein. Next, the tube delivers electrical heat in 20-second bursts to segments of the vein, causing it to shrink and collapse. Your doctor seals the vein, which is eventually absorbed by the body. Blood naturally reroutes to healthy veins.

The procedure is performed in the doctor’s office using local anesthesia and usually takes less than one hour. You can go home about 30 minutes later and return to your usual activities immediately. Side effects may include bruising and tenderness, which disappear within a few weeks.

Endovenous Laser

Our doctors may use an endovenous laser, which emits a highly focused beam of light to seal varicose veins. In this procedure, which is also called VenaCure™, your doctor punctures the skin and inserts an intravenous (IV) tube in the damaged vein. A laser fiber is inserted into the IV to give off heat inside the vein, damaging the vein’s wall. This causes it to shrink and collapse. The vein is absorbed by the body, and blood reroutes to healthy veins, relieving symptoms.

During the procedure, which is performed using local anesthesia, you wear special glasses to protect your eyes from the laser.

The procedure is performed in the doctor’s office and usually takes less than one hour. You can go home about 30 minutes later and return to your usual activities immediately. Some people experience bruising, but it typically goes away within a few weeks.

Nonthermal Ablation

Our doctors sometimes use nonthermal ablation techniques, which involve injecting chemicals into a vein to cause it to collapse and disappear.

Injectable Foam

Also called Varithena®, this procedure involves injecting a chemical into an affected vein to cause it to collapse. Blood is redirected to healthy veins nearby.

Your NYU Langone vein specialist numbs the skin on an area of the leg with a local anesthetic, makes an incision, and inserts a thin hollow tube called a catheter into the damaged vein. Then he or she injects a small amount of the chemical through the catheter into the vein.

The procedure takes less than an hour to complete, and you can go home the same day. You can resume your usual activities immediately, but your doctor may recommend avoiding exercise for up to two weeks.

Liquid Sclerosant

Also called ClariVein®, this technique uses a small, rotating metal wire and a liquid chemical that irritates a damaged vein’s walls, causing it to close. Compared to some thermal treatments, it requires fewer injections of local anesthesia.

Your specialist makes a tiny incision in the skin, then guides a catheter into the affected vein using ultrasound imaging. Next, he or she delivers the liquid through the catheter while the rotating wire helps to destroy the vein. Blood is rerouted to healthy veins nearby.

This procedure takes less time than other minimally invasive procedures, such as phlebectomy, and you can go home the same day.

Medical Adhesive

Also called VenaSeal™, this procedure uses a medical adhesive to close a varicose vein.

Your NYU Langone vein specialist punctures the skin of the leg and inserts a catheter using ultrasound guidance. Next, he or she delivers several precisely measured injections of a medical adhesive into the varicose vein and presses on it to compress the vein walls, closing them off. Blood is rerouted to healthy veins nearby.

The procedure takes less than an hour, and you can go home the same day.

Ambulatory Phlebectomy

In this procedure, varicose veins are removed through tiny punctures in the skin.

Your doctor injects a local anesthetic into the area of skin over a vein and makes a tiny incision. Then he or she inserts a thin metal hook, which looks like a small crochet hook, to pull the vein out of the leg. There is typically minimal discomfort, and any bruising or swelling is temporary, lasting a few days to a few weeks.

The procedure takes 30 minutes to one hour. Any scarring is slight and usually is barely noticeable within a year.

Sometimes, a phlebectomy is performed at the same time as an ablation.

Sclerotherapy

This procedure is usually reserved for cosmetic vein problems, including spider veins and some small veins that cause few or no symptoms.

Your doctor uses a fine needle to inject a liquid chemical into a vein, irritating the lining and causing it to swell shut. The body absorbs the vein, and blood reroutes to healthy veins.

The procedure typically causes no pain or discomfort, and you can go home immediately afterward and resume your usual activities.

Side effects include bruising and a brownish skin color, or pigmentation, on the leg. Bruising typically disappears within two weeks, but pigmentation changes can last for months before they fade away.

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