Did you have a follow up venous ultrasound? Not immediate post ablation, but in a few days. But since then, how long have you followed up with your vein surgeon? We do a 3 month, 6 month, and then a yearly follow up with patients once their treatment is completed. A certain number of patients develop venous insufficiency with significant reflux in their small saphenous veins and present with recurring symptoms of swelling, particularly below knee, bulging veins some times and reflux seen on venous ultrasound at the sapheno popliteal junction with a dilated small saph vein. Some also develop varicosities involving the segment of GSV below knee if the GSV was only closed from knee. So ideally you need reevaluation to treat the involved veins which will relieve symptoms.

Published on Jul 11, 2012

Without seeing you in person and checking with ultrasound, it is difficult to answer. Perhaps a second opinion from a board certified surgeon, vascular trained, might give you some answers. There are several other veins which can fail too. A vascular surgeon can also look and the venous and arterial systems and perhaps give you some answers.

Published on Jul 11, 2012

Just because you inject a vein or laser a vein does not guarantee that the vein will successfully shut down. You need to keep in mind that you have millions of branches within you vein structure connecting into some of the veins that you had treated. Any one of these branches can re-open a treated vein especially early on. That is why the only way to tell is to have your legs ultrasound periodically as you heal in. Assuming that the veins that were treated did successfully close down, there is no guarantee that your doc treated all of the refluxing veins in your legs. When veins are shut down, the blood will re-distribute into adjacent veins. This can cause some of those veins to dilate and start to reflux. That is another reason it is so important to periodically check the legs with an ultrasound. Your legs are heavy because of the fact that your venous circulation has not been fully repaired. The redness is from localized inflammation caused by your vein disease. It sounds like your legs have only been partly treated and need more work.

Published on Jul 11, 2012

You may still have varicosities if they were not treated following the ablation procedure. EVLT does not necessarily cause the varicosities to dissolve, and in my experience, microphlebectomies are usually necessary for varicose veins. Also, you should have a follow up venous ultrasound to ensure that the greater saphenous is closed and that the lesser saphenous vein is not refluxing.

Published on Jul 11, 2012

If the saphenous veins were incompetent to begin with (allowing reverse
flow) treating them should have only helped decrease venous congestion and
the size of the ankle and calf veins connected to the saphenous veins. If
8-10 weeks have passed since the procedures and no improvement has been
noted in the caliber of those varicosities, other causes of persistent
venous congestion should be ruled out, like missed accessory Great Saphenous
Veins or, more commonly, untreated incompetent perforator veins

Published on Jul 11, 2012

You need another venous ultrasound to see if you have other veins which are
insufficient like the deep veins, the small saphenous anterior accessory,
interspahenous, posterior accessory and other perforator veins. Lastly,
varicose veins may be primarily insufficient and you may just need the
varicose veins removed through small incisions. First get yourself
re-evaluated. What did your vein specialist tell you?

Published on Jul 11, 2012