How many endovenous laser ablation procedures do I really need to have?

I had the VNUS procedure last June, and then a phlebectomy in Sept. I started to feel pain again so I just got another ultrasound and I was told I need another ablation. Is that normal? I felt my whole procedure. It was horrible. Do I need to get a 2nd opinion?

Answers from doctors (7)


Intermountain Vein Center

Published on Jul 02, 2014

Make sure your physician is accredited by the American College of Phlebology. Usually, interventional radiologists are the best at these procedures. With the procedure, you should've felt the numbing but after that, you shouldn't have felt the procedures, especially if it was an ablation. If you felt the burning of the ablation that means there wasn't enough anesthetic around the vein. That can damage tissues. The best way to treat is to do all the ablations first, then move down to ambulatory phlebectomy and sclerotherapy.

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Answered by Intermountain Vein Center

Make sure your physician is accredited by the American College of Phlebology. Usually, interventional radiologists are the best at these procedures. With the procedure, you should've felt the numbing but after that, you shouldn't have felt the procedures, especially if it was an ablation. If you felt the burning of the ablation that means there wasn't enough anesthetic around the vein. That can damage tissues. The best way to treat is to do all the ablations first, then move down to ambulatory phlebectomy and sclerotherapy.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Jul 01, 2014

A second procedure is not unusual. The doctor needs to use better local anesthesia.

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Answered by Cosmetic Vein Centers of Texas

A second procedure is not unusual. The doctor needs to use better local anesthesia.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Jul 01, 2014

You should definitely seek a second opinion from an experienced vascular trained board certified surgeon with experience in treating varicose veins. You should not experience pain during the procedure except for occasional small "sticks" where the skin is numbed. In some people there can be more than one saphenous veins causing symptoms. The greater (long) saphenous is the most common but there short saphenous can develop reflux also. Not all pain, however, is necessarily caused by reflux which is why you your seek experienced opinion.

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Answered by Vein Specialties of St. Louis

You should definitely seek a second opinion from an experienced vascular trained board certified surgeon with experience in treating varicose veins. You should not experience pain during the procedure except for occasional small "sticks" where the skin is numbed. In some people there can be more than one saphenous veins causing symptoms. The greater (long) saphenous is the most common but there short saphenous can develop reflux also. Not all pain, however, is necessarily caused by reflux which is why you your seek experienced opinion.

Published on Jul 11, 2012


Lone Star Vein Center

Published on Jun 30, 2014

There is certainly no harm in getting a second opinion. If the problem is explained thoroughly it should be noted that most cases are a multi-step approach, and it does take time to complete the process. Did you notice significant improvement after your other procedures? It would be interesting to see your ultrasound results initially versus your current. I'm also concerned that your experience was described as 'horrible'. More
than >95% of our patients say it is very tolerable and do not take any medication before or after their procedures.

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Answered by Lone Star Vein Center

There is certainly no harm in getting a second opinion. If the problem is explained thoroughly it should be noted that most cases are a multi-step approach, and it does take time to complete the process. Did you notice significant improvement after your other procedures? It would be interesting to see your ultrasound results initially versus your current. I'm also concerned that your experience was described as 'horrible'. More
than >95% of our patients say it is very tolerable and do not take any medication before or after their procedures.

Published on Jul 11, 2012


Heart and Vein Center

Published on Jun 29, 2014

The possibilities are multiples. You could have a re-canalization (re-opening)?of the treated vein or you could have new veins that are now causing your problems.

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Answered by Heart and Vein Center

The possibilities are multiples. You could have a re-canalization (re-opening)?of the treated vein or you could have new veins that are now causing your problems.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Jun 27, 2014

Yes.

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Answered by Bella MD Laser Vein and Aesthetic Center

Yes.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jun 27, 2014

The venous ultrasound is the most significant part of the venous evaluation to determine what is best for you. I do no know if you have recurrence of your symptoms form failure of the initial ablation or if the symptoms are due to new reflux. If you have reflux, and have symptoms due to reflux, then ablation is indicated.

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Answered by Vanish Vein and Laser Center

The venous ultrasound is the most significant part of the venous evaluation to determine what is best for you. I do no know if you have recurrence of your symptoms form failure of the initial ablation or if the symptoms are due to new reflux. If you have reflux, and have symptoms due to reflux, then ablation is indicated.

Published on Jul 11, 2012


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