I had endovenous laser ablation done 3 weeks ago. There was no significant pain, and the follow up ultrasound that was performed a week later showed no signs of deep vein thrombosis. But, I am experiencing more tightness and swelling in my lower leg and ankle than before the procedure. What does this indicate ?
Thank you for your question. Not all cases are the same and not everyone responds to treatment in the same way. However, I recommend that you follow up again with your provider and let them re-evaluate with ultrasound imaging to check for patency of your venous system if the swelling worsens. It is also important to communicate any question or concern to your provider post-treatment.
All the best!
Published on Jul 11, 2012
You likely need other procedures, such as additional ablations or sclerotherapy. Rarely does one ablation treat everything in the leg.
Published on Jul 11, 2012
It is hard to determine when the swelling will subside since each patient is different. Contact your treating physician for a follow-up appointment.
Published on Jul 11, 2012
A repeat ultrasound will reveal the reason for swelling. Even if the ultrasound was normal one week after treatment, it should be repeated to rule out thrombosis if swelling progresses at this point.
Published on Jul 11, 2012
It is difficult to say precisely. It really depends on what your leg looks like on the inside. The mistake a lot of docs make when treating a patient's veins is that all they treat is/are the saphenous veins. Once done, they are under the delusion that the treatment is complete. The reality is that the treatment has only begun. You have mile and miles of vein structure in each leg. Merely treating 2 feet of vein does not fix the problem. What your doc did was address only a couple of feet of your vein problem when in fact you probably have 50 yards of vein disease. The tightness is probably from the treated vein having been turned into scar tissue. New scar tissue does not stretch well thus the tightness. The swelling is another issue. It is unlikely to be due to a clot since you have been checked. What the swelling is probably from is one of two things. 1. Your body is adjusting to the treated vein being closed. Please note that I am assuming that the treated section of your vein was "all" refluxing. Not just a portion and your doc elected to close all of it. When you close a normal section of vein, especially a relatively long segment, your body has not adjusted to that section being bad. Thus you get leg swelling. Don't laugh. Some docs who do not know any better will do this. 2. You can have secondary branches in your leg that are also abnormal that were never treated. Like I was saying, a lot of docs only treat part of a person's vein disease. In order for the treatment to be effective and to generate the result that most patients want, you really need to address all parts of the leg from the large saphenous veins all the way out to the skin. When all of the refluxing veins in the leg are treated, the end result is typically really good. The person gets a leg that not only looks good but also feels good and flows efficiently. So, to answer your question regarding "what does this indicate?"; it indicates that you did not get a "complete" treatment. If you would like for us to look into what was not done, please give us a call so that we can tell you what needs to happen to get the results you are looking for.
Published on Jul 11, 2012
The swelling you describe should clear soon.
Published on Jul 11, 2012
There is swelling when you close a major axial vein. This will last up to several months depending on the amount of walking, stocking wear to enhance the calf muscle pump, and other factors. DVT can develop, but ultrasound can detect this if suspected.
Published on Jul 11, 2012
It is unusual to experience swelling in the ankle post-endovenous ablation. There may be some localized inflammation in the area of treatment in the medial thigh or posterior calf (depending on which saphenous vein was ablated). You should be re-examined by ultrasound, continue to wear the compression hose, and elevate your leg as often as possible. Deep vein clots should be ruled out.
Published on Jul 11, 2012
This is very common post-laser ablation, and probably occurs in about 10% of patients. The post-venous sonogram shows no DVT, so this is a local problem secondary to swelling from the tumescent and laser. The laser burns the vein and also heats the surrounding tissue, resulting in an inflammatory reaction leading to swelling in some. Also, there could be some localized lymphedema secondary to the laser treatment. Support stockings, walking, and elevating the legs at night will resolve this over 6 to 8 weeks.
Published on Jul 11, 2012
I would follow up with your doctor since there are several things that may cause increased swelling and tightness. Please get it checked out.
Published on Jul 11, 2012
Swelling can last between 2-4 weeks after endovenous laser ablation.
Published on Jul 11, 2012
1. Compression stocking might be tight at upper areas and cause more edema below that point
2. Make sure you are taking anti-inflammatory that is prescribed by your doctor or Arnica
3. Try to exercise as much as possible, but don't overdo it or strain yourself
4. Follow up with your doctor to have ultrasound to rule out lymphatic problems or other reasons
Published on Jul 11, 2012
The treated vein probably still has inflammation and needs to heal. Ice and NSAIDs are the typical treatment for this. Talk with your treating physician to discuss these options.
Published on Jul 11, 2012