After the doctor performed the ultrasound to find my greater saphenous vein, he said I wouldn't notice much difference because he could only close about a 6 inch section. What are my options now? I have mild ankle swelling & one varicose vein.
This is difficult to answer without seeing you in person and knowing where in the GSV the reflux is located. If it is at the proximal end (top of the leg) if may help alleviate your symptoms if the branches are fine. Again, perhaps get a second opinion from an experience vascular trained surgeon who specializes in doing these treatments.
Published on Jul 11, 2012
The larger caliber and greater degree of reflux your proximal saphenous vein has before it splits, the more likely VNUS closure will help. If the saphenofemoral junctional (SFJ) valves are incompetent, VNUS would be a good idea. If your SFJ is competent, your saphenous vein is small, and reflux is mild, then I would agree with your doctor.
Published on Jul 11, 2012
Unless you have had your greater saphenous vein closed or removed in a previous procedure, it is quite unlikely that it is only six inches long. There may be incompetence or reflux in only a six-inch segment, but the length of the greater Saphenous vein itself, I would venture to say, is a good deal longer. Having said that, this does not mean that you are not symptomatic. Did you see a board-certified vascular surgeon, or perhaps another type of vein specialist? I would remind you that it is your prerogative to seek a second opinion and that includes a second ultrasound study (a full study showing both superficial and deep vein incompetence as well as reflux time). I would also suggest that you seek out a vascular surgeon for this second opinion as it might bring a slightly different professional perspective to your case.
Published on Jul 11, 2012
There should be other additive therapies done in conjunction with RF ablation in this situation. It seems like the doctor is not offering comprehensive vein care, and may not be that experienced. But in all fairness, it is not 100% fair to say that without seeing you and your scan.
Published on Jul 11, 2012
You would likely benefit from VNUS closure even with only inches to close. If you have venous insufficiency, it doesn't matter if there are many saphenous branches or none at all. The pressure and congestion will end up in your ankle and calf. After closure, you will need a phlebectomy and foam sclerotherapy to treat the branches.
Published on Jul 11, 2012
You may need to have more assessments and therapies. It is good to start with physical therapy for lymphedema.
Published on Jul 11, 2012
In many cases, VNUS closure can still help even if the greater saphenous vein splits off to other branches.
Published on Jul 11, 2012
There are several options that may be available to you. First, laser ablation uses a smaller and more flexible catheter, which may be able to negotiate into the smaller branches. Second, ultrasound-guided foam sclerotherapy of the branches will help to close them. Third, you may want to seek a consult from an accredited vein specialist who has experience dealing with this problem. After evaluating you and performing tests, he/she may be able to advise you on the best and most appropriate treatment.
Published on Jul 11, 2012