A. Q: What is venous ablation? A: Venous ablation is an operation that treats different types of venous disease. It works by closing or removing the diseased vein so that blood can no longer flow through this vein, but instead returns to the heart through another vein. Venous ablation is only used for those who are unable to undergo simple treatment. Venous ablation can be done in several different ways: Sclerotherapy: In this procedure, the doctor injects chemicals into the diseased vein causing the vessel itself to close. The vein remains in place, but it no longer carries blood flow. Sclerotherapy can be done on an outpatient basis under local anesthesia. Radiofrequency or laser ablation: In this procedure, the doctor inserts a special wire into the diseased vein. This wire raises the temperature of the vein and closes it from the inside (Figure 1). The vein remains in place, but the blood flow no longer passes through it. These operations require only a small puncture or incision in the skin, and the amount of anesthesia is so small that the surgeon can often perform them on an outpatient basis. Vein ligation or vein stripping: A procedure to remove a diseased vein. It needs to be done in a hospital or surgical center and the vein is then removed through many small incisions after anesthesia. Second, can I choose which operation to do myself? A: No, usually not. The doctor will advise you which operation to choose based on the type of venous disease. C. What preparation do I have to do? A: It depends on what operation you are going to undergo and the doctor will give you detailed instructions about the operation. In general, patients undergoing sclerotherapy, radiofrequency or laser ablation only need to be sedated with medication prior to the procedure. Some patients will need to stop taking specific medications prior to the procedure, but this is not common. Patients undergoing vein ligation or stripping will have more complex requirements because of the surgery involved. Q: What happens after venous ablation? A: After vein ablation, most people will need to do the following: Walk several times a day for a few minutes at a time Avoid standing or sitting for long periods of time Support your legs while sitting (such as with a pillow) Avoid heavy lifting or exercise for 1 to 2 weeks after vein ablation Depending on the type of ablation procedure, you may be asked to wear a special bandage or stocking (called a “compression bandage ” or “compression stockings”). These bandages or stockings will apply a steady pressure to your leg and help prevent stagnation of blood in the veins. You may want to return to your doctor some days after surgery for a test called an “ultrasound” to check for any blood clots forming in your leg. If your doctor tells you to have this test done, it is very important for you to have it done. Q: What problems can occur after vein ablation? A: The problems that can arise from different operations are different. In general, problems include: Blood clots forming in the leg Subcutaneous bleeding forming a soft mass called a “hematoma” In people who have undergone vein ligation or stripping, there is a risk of: Wound infection Nerve damage Q: When should I contact my doctor or nurse? A: Contact your doctor or nurse immediately if you experience any of the following problems: Your leg or foot feels tingly or cold while wearing a bandage or elastic stocking, or the skin on the treated side of your toe turns white or purple in color – these symptoms mean the bandage is too tight. You can remove the bandage or stocking, but you will need to contact your doctor or nurse. Your leg or foot feels tingly or cold while wearing the bandage or elastic stocking, or the skin of the treated toe turns white or purple – these symptoms mean the bandage is too tight. You can remove the bandage or elastic stocking, but you will need to contact your doctor or nurse. Severe pain or swelling that is not relieved by taking the pain medication prescribed by your doctor – these symptoms indicate that a blood clot may have formed in your leg. Post-operative bleeding that leaks blood through the bandage, even though the doctor has adjusted it.