I am 25-year-old female, and 3 years ago I started having spider veins on my thighs and blue slightly bulging veins behind my knee on both legs. I have no symptoms, but had ultrasound done, and found that I have 0.3 to 0.5 sec reflux in GSV in right leg. Do I need to get immediate treatment, or what do I have to do next?
The 'reflux' in your GSV is within normal limits and not an indication of any abnormality of your GSV. Reflux greater than 0.5 seconds is considered abnormal. Your 'spider veins' and 'blue slightly bulging veins' are not at all related to your, apparently, normal GSV. In addition, ablating your GSV (by radiofrequency occlusion) will have no effect on the veins behind your knees nor in preventing more of these veins (if you are so pre-disposed) from developing.
Published on Jul 11, 2012
The accepted standard for reflux established by the American College of Phlebology is >0.5 sec for superficial veins. At 0.3-0.5 seconds, you are borderline. Based on the fact that you have spiders and bulging veins, you definitely have vein disease. Whether you require treatment or wish to pursue treatment depends on you. If you do not like the way your legs look, then you need to treat them. If you find that you have leg discomfort or heaviness, cramping, etc., then you treat them because you are starting to have symptoms from your vein issues. You should treat when you are ready because it does take some time commitment on your part to get your legs treated properly.
Published on Jul 11, 2012
Wear compression stockings. Your legs may feel better. You may have symptoms you don't know you have. Otherwise, the hose will help delay the progression of the disease. You are not ready for RFA quite yet.
Published on Jul 11, 2012
Spider and reticular veins can be treated with sclerotherapy. Significant reflux is greater then .5 seconds and unless you have varicose veins, it seems to me that closure is not indicated. Certainly, immediate treatment is not necessary.
Published on Jul 11, 2012
I would be reluctant to treat with endovenous thermal ablation for no symptoms as you describe. "Reflux" of 0.3 to 0.5 seconds is within the normal time for the valve to close. We define reflux in the saphenous vein as a reversal of flow lasting over 0.5 seconds. Thus, you are not describing real reflux. If someone is recommending radiofrequency ablation for a leg with no symptoms and valve closure time of less than 0.5 seconds, go elsewhere in the future.
Published on Jul 11, 2012
The criteria defining medical necessity are generally greater than 500 milliseconds (or greater than 0.5 seconds). If you are not having symptoms, I would be inclined to pursue conservative measures aimed at preventing progression of disease, such as wearing compression stockings, a walking regimen and weight loss, if applicable.
Published on Jul 11, 2012
Sounds like minor insufficiency. Was the test done standing? It should be.
Published on Jul 11, 2012