One of the most frequent questions asked is will the procedures hurt. This is often a difficult question to answer, because everyone experiences pain differently. Some patients report no pain after the procedure and for others the pain can be significant. For the purposes of this discussion we will discuss the average of what most of our patients experience.
The EVTA (endovenous thermal ablation) procedure utilizes radio frequency or laser energy to close long, large diameter veins. This procedure uses heat to close the vein permanently, however, the heat also can also cause temporary surrounding tissue damage which is what causes most of the post-procedure pain. Typically, the most painful part of the procedure is the injection of local anesthetic. Most patients tolerate these injections well. We offer patients a relaxing medication like valium or nitrous oxide that can help make these injections more tolerable. Patients often report two weeks of a mostly dull achy pain after the procedure. This can be constant for the first week and by the second week the pain reduces daily until it’s gone. An anti-inflammatory medication like ibuprofen is typically the best medication to treat the post-procedure pain. Alternatively patients may take Tylenol.
People often describe a cord like sensation that resembles a pulled muscle. This sensation results from the treated vein shrinking in length and causing a tightness. This can last for one to two months as the vein is resolving. Patient often become concerned that something will tear or break, but that does not happen and some mild to medium stretching of the leg can help this resolve faster.
One of the side effects of EVTA can be paresthesia or numbness, this usually occurs on the inside of the calf sometimes from the knee down to the ankle. This results from a sensory nerve that is close to the treated vein becoming ablated. The numbness is temporary for most patients but can take several months to resolve. Often while the nerve is repairing itself patients can experience a tingling or burning sensation. There is a small percentage of patients that this numbness never completely resolves in, and they describe a funny sensation while shaving their legs or putting on socks. This does not effect function of the leg at all.