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A step-by-step guide to varicose vein surgery

In his own words, Garnet Craddock, M.D., a general surgeon at Southern Vein Care, a service of Piedmont Physicians Group, explains endovenous ablation, an outpatient procedure that treats venous reflux disease using heat to seal varicose veins from the inside out.

Preparation: When we bring a patient in for the procedure, the first thing we do is prep them like we would in a sterile operating room. We will caution them to keep their hands away from where we are operating and take precautions to make sure we are keeping things very clean.

Initial Steps: At the beginning of the procedure, we will numb an area of the skin right below the knee with an injection. Using ultrasound guidance, we then place a catheter inside the vein we are treating. Usually the only discomfort a patient feels is when we numb the skin.

Main Procedure: We then pass the catheter up through the groin. The hardest part of the procedure is when we do what I call five little “beestings” above the knee where we are numbing the skin in five different places very rapidly. After that, we take another needle and create a halo of fluid around the vein.

The fluid pushes the vein against the catheter, which is now inside the vein. The halo of fluid absorbs heat, prevents damage to surrounding tissue and contains numbing medication so the patient does not feel any of the heat at all once the procedure starts. The setup for this procedure takes about 10 to 15 minutes, while the actual heat-sealing only takes about two minutes.

Final Steps: When the process is complete, our team removes the catheter and typically puts a small stitch in the skin where it was inserted and wraps the area with a compression bandage.

Some people are told to walk for about two hours after the procedure to prevent deep vein thrombosis (DVT). DVT is something everyone worries about in the vein world, but it is a rare complication.

Follow-up: We have done these varicose vein procedures for about 10 years now and have performed an ultrasound on everybody within three to five days after the procedure. We have not yet seen a patient with a clot after undergoing endovenous ablation. For more information about this procedure, visit Southern Vein Care or Dr. Garnet Craddock.

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