By Jill Buterbaugh, RN, MSN, CRNP, FNP-BC
To answer this question, you need to know that the venous system is divided into two categories, superficial and deep. The deep venous system vessels are critical vessels and they are never treated with ablation procedures. These are the vessels that if you get a blood clot in them, have a higher risk of traveling to the heart, lungs or brain. This system is evaluated prior to any ablation procedure to ensure it is open and functioning.
The superficial venous system is comprised of all the vessels from the skin down to the deep system. Some are visible on the skin surface but most are very small and not visible. Healthy veins in the superficial system are usually less than 3 millimeters in diameter, even the larger ones in this system.
Ablation procedures are procedures that are performed to destroy the larger diseased veins in the superficial venous system that are not functioning correctly and causing physical problems. It is done by floating a radio frequency catheter or laser fiber up through a large superficial vein to the junction where that vein meets the deep system and applying heat to the inside of the vein, shrinking the collagen and sealing the vein to close it. Although the veins treated are part of the superficial system, they are not usually visible to the eye on the surface of the skin. Once these veins are closed, blood is immediately re-routed into other superficial veins
When the veins are closed, the blood will travel through other veins increasing the pressure and flow in them. If these other veins are starting to fail, the increased pressure and flow can cause them to dilate further and become visible if on the surface of the skin. Venous insufficiency is the disease that causes varicose veins to develop. The disease is most often a result of genetics and is triggered by lifestyle habits and events that occur over time. The ablation process does not cause other veins to go bad but if the blood is re-routed through diseased veins, they will become detectible.
Treating varicose veins from venous insufficiency disease is a process in most cases and not just a one-time procedure. The correct way to treat the disease is to treat the largest veins with the most abnormal flow then see how the other veins respond. In most cases it takes more than one procedure to treat all the diseased veins. Once the vein is treated, it is destroyed and cannot come back but that doesn’t mean other veins in the same area will not go bad. Sometimes new varicose veins are visible right away, in other cases it will take years for them to develop.
If you had previous treatment to varicose veins and now have other large visible veins, it is certainly worth having an evaluation to see if further treatment is recommended.
For more information or to schedule an evaluation, please contact us at (814) 515-9919. We would be happy to answer your questions.