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I've heard that ELA hurts more than RO. Is this true? They sound like sort of the same thing; why would one hurt more than the other?
As a physician who has done both these treatments, I should respond: NO
The 1000+ patients who have received laser ablation of greater saphneous vericosity, have been very comfortable with their course after the treatment. There are many more important factors such as: Size of the varicose vein, its depth relative to skin, and hoe good tumescent local anesthesia was done. Therefore, in my opinion, the technique of the treating physician, and size and distance form the skin are most important factors. In my experience, patients reported similar symptoms after either treatment, and generally have tolerated them well. I prefer laser evndovenous ablation of greater saphenous
vein for different reasons. One important reason is the remarkably lower catheter cost and not having to use heparin infusion with laser ablation. It should be noted that, greater saphenous at thigh level is treated with the above techniques, and treatment of lower parts of greater saphenous varicosity and its accessory branches must be
planned and well executed to achieve good results. Foam sclerotherapy is, when administered properly, is a great modality for treatment of remaining varicosities, after treatment of greater saphenous vein by any method.
Generally there is minimal to mild pain after these procedures treated with ibuprofen as needed. There have been some studies suggesting that in the immediate week after the procedure that radiofrequency ablation patients experience a bit less pain however, than the laser patients. As to pain during the procedure there should be absolutely no difference, and no pain should be felt during the ablation if the local anesthesia is administered correctly.
When completed properly both procedures should be painless. Steps are taken to make sure that the heat from either procedure is not felt. They are very similar procedures that work very well.
Studies have shown that RFA may be somewhat less painful during recovery however studies have also shown that it may be somewhat less effective over the long term in a small percentage of patients as compared to EVLA.
In general they are both very similar and have similar results. They both generate heat that injures the vein.
As to pain during the procedure there should be absolutely no difference. No pain should be felt during the ablation if the local anesthesia is administered correctly.Generally there is minimal to mild pain after these procedures treated with at most ibuprofen being taken as needed. There are no head to head studies that have compared what laser and radiofrequency ablation patients experience. However the mild discomfort experienced for a week or two after the treatment is certainly very similar.
The pain during the procedure is minimal and the same. However,
radiofrequency occlusion has been shown in medical studies to have less
post-procedure pain and bruising compared to laser ablation. The
difference is significant.
Overall the two procedures are very similar in terms of both pain afterwards and long term results. They are both very well tolerated by patients. Newer lasers are less painful than older generation lasers.
The type of energy used is different between the two methods.Each one of the companies that produce these devices have claims of differences on how much pain the patient experiences. In reality there is not much difference. It all depends on the individual patient pain threshold, extent of his/her disease, anatomy and technique employed by the physician.
It may be slightly more uncomfortable in the first day or two. The pain during the procedure is minimal and the exact same.
The amount of pain one experiences from either procedure is very subjective.
The higher level of baseline anxiety one has, the more "pain" one usually
experiences. For this reason, some sort of nerve pill like artisan or
valium is very helpful as a pre med. I have used a variety of lasers and
have found the cool touch causes much less pain post procedure than my older
laser with a 940 nm wavelength. During the actual procedure you should have
little to no pain related to the actual laser or radiofrequency sealing of
the vein. If you experience pain or burning during the procedure, you
should make this known and request additional fluid be placed in and around
the part of the leg that is "burning." In my experience of nearly 5000
ablations with radiofrequency and laser, I have found the RF to be faster,
easier to locate the tip and generally is my [preferred method for a
straightforward great saphenous vein which I usually close from below the
knee to the groin. Otherwise the laser (1320 nm) is my preferred method for
the smaller veins such as the small saphenous, anterior accessory great
saphenous vein and intersaphenous vein as well as perforator veins and
residual branches after previous stripping or endovenous ablations. I make
my decisions based on the anatomy of the veins to be treated rather than the
potential pain since I have notice very little difference between closure
fast and the 1320 nm length.
Some reports state that RO is less painful post procedure than ELA. This has not been my experience. Both procedures are well tolerated with minimal discomfort during the procedure. Post procedure discomfort is temporary and is patient dependent and is usually treated with anti-inflammtory agents.