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How long can I wait to have my great saphenous vein treated?

I recently went in to have sclerotherapy on two veins on the lower left leg. I had endovenous laser treatment (EVLT) on the small saphenous vein and it was VERY, VERY painful. The doctor now wants to do the great saphenous vein, but I have reservations. How long can I wait to have it done? Is there a time frame?

The information provided by medical professionals in the Q&A is for informational purposes only, and is not a substitute for individualized medical advice, diagnosis or treatment by a qualified health care provider.

Answers


Replied on 4/24/2013

By: VeinSolutions - Edina  |  
Edina, MN


Usually we have our patients wait at least two weeks between closure procedures. Your reference to the procedure being very painful is quite unfortunate. I'm sorry it was so uncomfortable for you. Venous ablation, whether it is via radiofrequency heat (VNUS Closure) or laser (EVLT), should not be painful. We use a combination of conscious sedation with injected Tumescent anesthesia. When performed properly, there should be little to no discomfort with this procedure. We have made the decision to use the VNUS closure procedure (radiofrequency heat) instead of EVLT (laser heat) because we found there was less damage to the tissue surrounding the vein being closed and additionally, appreciably less post-procedure discomfort. Whichever technique is used though, the overall procedure should not be that painful. Perhaps you should discuss your concerns with your current provider and, if you feel inclined, move in a different direction and at least speak with other vascular surgeons about the procedure and your concerns regarding the pain involved.


Replied on 4/23/2013

By: Cosmetic Vein Centers of Texas  |  Mark E. Skellenger, M.D.
Houston, TX


The doctor needs to use a better local anesthesia to ensure that pain and discomfort are not issues. As for when you should have the operation, it can be done at any time.



Replied on 4/22/2013

By: VEIN911  |  Christopher Pittman, MD
Tampa, FL


You can wait forever to have your greater saphenous vein treated if your symptoms are not lifestyle limiting. On the other hand, endovenous laser treatment of either the great or small saphenous veins should not be very painful. It is typical to treat proximal (higher up the leg) vein disease before distal (further down the leg) vein disease, so it's unclear why the small saphenous vein was treated first. If you have lost confidence in your vein care physician, then seek another opinion. The skill and experience of vein care practitioners varies widely, unfortunately.


Replied on 4/22/2013

By: Bella MD Laser Vein and Aesthetic Center  |  David A. Engleman MD, FACC
Dallas, TX


Get a second opinion. I see lots of unnecessary closures.


Replied on 4/22/2013

By: Advanced Vein Center  |  Dr. Kevin Baskin, M.D.
Dr. Ahmad, M.D.
Dr. Mauricio Giraldo, M.D.
Hopewell, PA
Moon Township, PA
New Castle, PA
Frisco, TX
Cranberry Township, PA

Cranberry Township, PA


I am sorry to hear about your discomfort. I can understand that you would be anxious about another similar procedure. It is important to have a frank discussion with your doctor about your painful experience, and to develop a plan together to assure - to the degree possible - that the next procedure is not painful. For most patients, this is not a painful procedure. To answer your question, the effects of varicose veins are seldom life-threatening, so theoretically you could never have the great saphenous treated if you wished to avoid the procedure. However, if there is significant reflux in the great saphenous vein that is causing significant symptoms (and I presume this is true since your doctor wants to treat this vein), then a prolonged delay could actually lead to reopening of other treated veins in the same leg. It sounds like your concern is not whether treating this vein is the right thing to do, but whether you will have to suffer similar pain again. Have that discussion with your doctor, and if the plan doesn't meet your expectations, consider getting a second opinion.


Replied on 4/22/2013

By: Advanced Vein & Laser Centre  |  Richard Rosenfeld, M.D., ABPH
Libertyville, IL


I'd suggest you review your post-operative course with the treating physician. Is there a time frame? NO


Replied on 4/22/2013

By: Americas Vein Centers - Southborough  |  Dr. B. Bergus M.D., R.V.S.
Phlebologist

Southborough, MA


There usually is no time frame.


Replied on 4/22/2013

By: Laser Vein Center  |  Thomas Wright, M.D., F.A.C.P., R.V.T.
O'Fallon, MO


Unless you have a venous ulcer, which is not mentioned, there is no set time frame for when you need to have refluxing saphenous veins treated. If you have mild symptoms from your varicose veins, there is little harm in waiting. However, the condition may slowly get worse over time, although it will probably occur over years and not weeks.


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