What is endovenous laser ablation?
Endovenous laser ablation is a minimally invasive technique used for treating some types of vascular malformations.
- An interventional radiologist, using image guidance, inserts a catheter into the malformed vessels of the affected area. A laser fiber is then inserted through the catheter.
- When activated, the laser produces energy that causes the blood within the abnormal veins to heat and bubble, damaging the cells in the wall of the vein.
- The malformed veins shrink in the weeks to months following the procedure and your child’s body reroutes blood through healthy, well-functioning veins.
How Boston Children’s Hospital approaches endovenous laser ablation
This procedure in children is different than in adults, because children have smaller and more delicate blood vessels. Our interventional radiologists are skilled in using the specialized techniques and small catheters necessary to perform endovenous laser ablation in children.
In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses and technologists who specialize in caring for children who have undergone interventional radiology procedures and treatments.
We perform endovenous laser ablation in our suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.
Frequently asked questions
When is endovenous laser ablation needed?
Vascular malformations are congenital conditions in which the blood or lymph vessels are abnormally formed, often causing pain, swelling and disfigurement. The procedure can ease some of these symptoms.
How should I prepare my child for procedure?
Explain to your child in simple terms why the test is needed and what will happen. You can say that you will be close by and that she may bring a favorite toy or blanket into the procedure room.
What will happen before the procedure?
A staff person from the hospital will call you a few days before your appointment to let you know where to go when you arrive at the hospital, as well as to give you instructions about when your child needs to stop eating, drinking, and/or taking medications.
When you arrive at the hospital:
- The interventional radiologist will talk to you about the procedure and ask you to sign the consent form. (You must be your child’s legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring the paperwork showing proof of legal guardianship.)
- If your child will be having general anesthesia, a medicine that causes deep sleep, an anesthesiologist will meet with you to explain this and have you sign another consent form.
- Your child will change into a hospital gown.
- You and your child will be taken the room where the procedure will be done.
- A nurse or anesthesiologist may start an intravenous (IV) line.
- Once your child is asleep, you will be escorted to a special waiting area.
What happens during the procedure?
- The radiology technologist cleans the skin with a special liquid to help prevent infection.
- The interventional radiologist inserts a catheter through a tiny opening in the skin. The laser is then threaded through the catheter and into the blood vessel to be treated.
- In many cases, the radiologist will also inject a chemical agent called a sclerosant through the same catheter to cause further shrinkage of the malformed veins.
- When the procedure is finished, the radiologist will remove the laser and the catheter. The nurse then applies a dressing to the tiny opening in the skin. If the vascular malformation involves an arm or leg, a tight wrap or stocking is put on.
What happens after the procedure?
We will take your child to the Post Anesthesia Care Unit (PACU, or recovery room) to be monitored closely for several hours. You may stay in the unit with your child during this time.
How will I learn the results?
The interventional radiologist will speak with you after the procedure and explain the findings and results.
How long will recovery take?
The healing process can take several weeks to several months, and your child may feel some pain or “tightness” as the area heals. We may prescribe pain medication; give it to your child as prescribed by your doctor or nurse practitioner.
We will also advise you on the level of activity your child can have after you go home.
Is endovenous laser ablation safe?
This procedure has successfully decreased pain, swelling and disfigurement associated with certain types of vascular malformations. As performed by trained interventional radiologists, this is a safe and effective procedure. However, as with all procedures, there are potential side effects and complications, which will be explained to you by the interventional radiologist before you are asked to consent to the procedure.
This procedure uses image guidance to visualize your child’s blood vessels and assist the radiologist while performing the procedure. We believe that the benefit to your child’s health outweighs the risk related to any x-ray exposure that occurs during the procedure. Because children are more sensitive to radiation than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.
Boston Children's Hospital
300 Longwood Avenue
Boston MA 02115