I have a deep vein clot and I was wondering if I can have an ablation to close the the vein on the inside of my leg?
I would not recommend it. I think that it is more important to let the clot resolve before proceeding with any other surgery.
Published on Jul 11, 2012
A deep vein clot or thrombosis (DVT) is typically a more acute problem where a blood clot develops in one of the veins in the deep venous system. Because this can have more serious consequences, it is treated aggressively with anticoagulant medications such as Heparin and Coumadin that prevent the clot from progressing and allow the body to break it down,dissolving the clot and thereby preventing further complications. It is usually recommended that a deep vein thrombosis completely resolve before an elective ablation on a superficial vein be performed. This would prevent any added irritation to the deep system that could result in further aggravation to the deep vein clot.
Published on Jul 11, 2012
With recent history of DVT (deep vein clot), a very thorough evaluation of the superficial and deep system has to be done by a Phlebologist or vascular surgeon to see if the procedure is indicated and the timing of it. If superficial vein ablation is indicated, it is very possible that you will need anticoagulation.
Published on Jul 11, 2012
Depends on the age of the clot, where located, family history and many other factor. The patient needs to get a detailed history and exam.
Published on Jul 11, 2012
In most cases when deep vein thrombosis and saphenous vein reflux coexist, ablation of the saphenous vein is possible after a period of time. The "hypercoagulable" state must have ended and the clot treated. However, there are rare cases where the saphenous vein acts as a bypass conduit for the blocked thrombosed deep vein, in which case the saphenous vein should not be treated.
Published on Jul 11, 2012
If you have had a DVT, you may still be able to have an endovenous ablation. It depends on where the DVT is and how large it is. Basically the blood has to be able to get back up your legs somehow. After you have the ultrasound exam you need to discuss this with your doctor. More importantly, determine what the endovenous ablation will accomplish.
Published on Jul 11, 2012
Absolutely NOT! If you have a clotted deep vein, then your peripheral (superficial system/long or short saphenous) is the main return path to take the blood back to heart and lungs for re-oxygenation.
Published on Jul 11, 2012
Usually not.
Published on Jul 11, 2012
First of all, you do not mention the age of the clot, the treatment, and which particular vein you intend to have ablated. That being stated, I would advise against any ablation until the deep vein clot is resolved. It is necessary to determine the extent of deep vein valve damage and whether you will have post thrombotic
syndrome. If the saphenous vein is incompetent, it can be ablated after a DVT resolves if it is expected that swelling or pain will be relieved to some extent.
Published on Jul 11, 2012
If you have an acute DVT this would be a contraindication to saphenous vein ablation. However, if you have been treated for DVT in the past and an ultrasound shows good collateral flow around the old DVT, and you are symptomatic from saphenous valvular reflux, you could have the vein ablated. These types of cases are often complex and you should be evaluated by a vascular or vein specialist with experience in this area.
Published on Jul 11, 2012
Having a clot in the deep vein of the leg that has not resolved and is occluding the deep vein system is a contraindication for endovenous laser ablation of the superficial veins.
Published on Jul 11, 2012
Saphenous vein ablation is not appropriate if a patient has recent DVT. Patients who have experienced DVT in the remote past which has resolved may be treated for saphenous vein incompetence with endovenous ablations. One must be sure that there is adequate outflow of venous blood from the leg which is not dependent upon the saphenous vein before performing ablation in patients who have residual obstructive changes from old DVT, especially in the veins of the thigh. If there is so much residual obstruction from DVT in the thigh veins that the saphenous vein is an important pathway for blood to pass around the obstruction, ablation of the saphenous vein could make the patient much worse. Detailed ultrasound evaluation of flow rates in the veins of the thigh is important to evaluate this circumstance.
Published on Jul 11, 2012
Possible. Depends on the anatomy.
Published on Jul 11, 2012
It will depend on the physician. Some physicians like to see improvement of the DVT before you have any other treatment for varicose veins. It will depend on the severity of the clot. If those deep veins are completely occluded, then I would doubt that the physician would treat.
Published on Jul 11, 2012
Depends on a number of factors. Chronic blockage of deep veins? Acuity of the deep clot, current symptoms.
Published on Jul 11, 2012