Endothermal Ablation. During endothermal ablation, the veins affected by reflux are treated from the inside with heat energy. I perform this under local anaesthetic under ultrasound guidance. With an ultrasound probe on the skin, the unhealthy vein is located and the skin overlying the vein is numbed with local anaesthetic and then a small needle is inserted into this vein. Through the needle a fine catheter is inserted into the vein and advanced along the vein under the skin and positioned accurately to the site where the superficial vein joins the deep vein, confirmed by ultrasound. The vein is then numbed with a series of local anaesthetic injections, again, guided by ultrasound. Thereafter, the vein is heated from the inside – hence the term endothermal ablation – to a temperature at which the vein is closed and cauterised and the cells of the vein are sterilised. Thereafter, thvein cannot recover, re-open or re-join with the deep veins and the superficial venous reflux is effectively cured. After endothermal ablation the varicose veins disperse, varicose eczema or leg ulceration can heal, and any associated spider veins will also disperse. Large varicose veins can be extracted at the same time, a procedure called Phlebectomy.
The avoidance of general anaesthetic ensures that these treatments are extremely safe. NICE – the National Institute for Health and Care Excellence – does not comment on the use of local anaesthetic versus general anaesthetic. However, in my opinion, local anaesthetic is much, much safer. Serious complications after endovenous treatments performed in this way are almost completely avoided. Since these endothermal treatments are performed through pinpricks in the skin guided by ultrasound at all times, there is virtually no scarring and complications such as infection and nerve injury are extremely rare compared to surgical stripping. In addition, these treatments can be performed without admission to hospital and after treatment people can return to normal activities such as driving and get back to work very quickly.
The results of endothermal ablation, ultrasound guided foam sclerotherapy and phlebectomy at The Melbury Clinic are excellent. The clinic complies with NICE Clinical Guideline CG168 and it meets the NICE Quality Standard QS67.
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