I had EVLA seven months ago and the doctor won't offer any solutions for my symptoms, what should I do?

I had endovenous laser ablation on both legs last August, yet the swelling and aching persists long after treatment. The MD who treated me is more or less ignoring the issues. I can't live like this, I am 40 years old. I thought the procedure was suppose to help, not disable me. Are my symptoms normal? What should I do about the unhelpful doctor?

Answers from doctors (14)


Owensboro Heart & Vascular

Published on Apr 10, 2021

Need to look at some other missing issue with vein system
That means you need to look for some other vein specialist

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Answered by Owensboro Heart & Vascular

Need to look at some other missing issue with vein system
That means you need to look for some other vein specialist

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Mar 29, 2013

You are not alone. Unfortunately, most "vein treatment docs" only treat part of the problem. Most often than not, an EVLA does not resolve a patient's complaints. A person's leg can have over 25 miles of vein structure and since vein disease is inherited for most people, you can have defective veins anywhere within those 25 miles. Therefore, when your doc sees an abnormal saphenous vein inside your leg, it should tell him that you have vein disease and that it is very unlikely that the saphenous vein is the only vein that is bad. In fact, most people do not realize that most of the veins that are visible on the skin surface of the legs are abnormal. It is not because you have thin skin or are not tan like many people like to think. Those veins are dilated and are considered varicose veins despite the fact that they may or may not protrude above the skin surface. So, when your doc only treats your saphenous vein, he/she is essentially only treating maybe 5% of what you have that is dysfunctional. What you need to do is find another vein doc who knows how to treat all aspects of your vein structure. Only when you have addressed all of your vein disease will you see your discomfort improve.

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Answered by The Sheen Vein Institute

You are not alone. Unfortunately, most "vein treatment docs" only treat part of the problem. Most often than not, an EVLA does not resolve a patient's complaints. A person's leg can have over 25 miles of vein structure and since vein disease is inherited for most people, you can have defective veins anywhere within those 25 miles. Therefore, when your doc sees an abnormal saphenous vein inside your leg, it should tell him that you have vein disease and that it is very unlikely that the saphenous vein is the only vein that is bad. In fact, most people do not realize that most of the veins that are visible on the skin surface of the legs are abnormal. It is not because you have thin skin or are not tan like many people like to think. Those veins are dilated and are considered varicose veins despite the fact that they may or may not protrude above the skin surface. So, when your doc only treats your saphenous vein, he/she is essentially only treating maybe 5% of what you have that is dysfunctional. What you need to do is find another vein doc who knows how to treat all aspects of your vein structure. Only when you have addressed all of your vein disease will you see your discomfort improve.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on Mar 21, 2013

Whenever we have a patient with pain or discomfort following surgery, we recommend that they come in so we can evaluate the problem. It is all about providing excellent patient care. You should seek a second opinion from a vein specialist you can trust and who you know will tend to your concerns.

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Answered by Americas Vein Centers - Southborough

Whenever we have a patient with pain or discomfort following surgery, we recommend that they come in so we can evaluate the problem. It is all about providing excellent patient care. You should seek a second opinion from a vein specialist you can trust and who you know will tend to your concerns.

Published on Jul 11, 2012


Advanced Vein Center

Published on Mar 19, 2013

You should get a second opinion. This includes an ultrasound of both legs to determine if there is any residual reflux.

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Answered by Advanced Vein Center

You should get a second opinion. This includes an ultrasound of both legs to determine if there is any residual reflux.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Mar 18, 2013

Find an interventional radiologist, if you are not seeing one already. There could be other veins that were left untreated that are causing those symptoms. Sometimes after an ablation, the symptoms can persist for 6-12 months.

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Answered by Intermountain Vein Center

Find an interventional radiologist, if you are not seeing one already. There could be other veins that were left untreated that are causing those symptoms. Sometimes after an ablation, the symptoms can persist for 6-12 months.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Mar 17, 2013

See another vein doctor and be sure he/she is a surgeon.

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Answered by Cosmetic Vein Centers of Texas

See another vein doctor and be sure he/she is a surgeon.

Published on Jul 11, 2012


Heart and Vein Center

Published on Mar 17, 2013

Your best option is to obtain a second opinion from a physician that is board certified in Phlebology.

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Answered by Heart and Vein Center

Your best option is to obtain a second opinion from a physician that is board certified in Phlebology.

Published on Jul 11, 2012


Vein 911

Published on Mar 16, 2013

Your symptoms are not normal and you should seek a second opinion. Almost every vein patient experiences improvement after proper treatment. Unfortunately, there is wide variation in the skill and experience of vein
care practitioners. Too many perform only EVLA and fail to offer the usually necessary ancillary procedures like ultrasound-guided foam sclerotherapy and/or ambulatory phlebectomy. Not uncommonly, the critically important ultrasound mapping study is poorly performed and/or interpreted. Seek a second opinion!

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Answered by Vein 911

Your symptoms are not normal and you should seek a second opinion. Almost every vein patient experiences improvement after proper treatment. Unfortunately, there is wide variation in the skill and experience of vein
care practitioners. Too many perform only EVLA and fail to offer the usually necessary ancillary procedures like ultrasound-guided foam sclerotherapy and/or ambulatory phlebectomy. Not uncommonly, the critically important ultrasound mapping study is poorly performed and/or interpreted. Seek a second opinion!

Published on Jul 11, 2012


Arizona Vein Specialists

Published on Mar 16, 2013

The symptoms should be less by this time. Patients state they have slight discomfort that persists for up to 6 months generally, but a lot less. Does wearing compression stockings produce any improvement? Sometimes wrapping a six inch ace wrap on the thigh and wearing stockings is necessary since
the stockings do not compress much at the top. Once this is done, persistent pain may be a sign of nerve damage or a deep vein blood clot. Do you have swelling? What is the distribution of the pain? These questions are best understood by a board-certified vein specialist. You should seek a second opinion at this time. Remember, the goal is to help you enjoy life, not punish the doctor.

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Answered by Arizona Vein Specialists

The symptoms should be less by this time. Patients state they have slight discomfort that persists for up to 6 months generally, but a lot less. Does wearing compression stockings produce any improvement? Sometimes wrapping a six inch ace wrap on the thigh and wearing stockings is necessary since
the stockings do not compress much at the top. Once this is done, persistent pain may be a sign of nerve damage or a deep vein blood clot. Do you have swelling? What is the distribution of the pain? These questions are best understood by a board-certified vein specialist. You should seek a second opinion at this time. Remember, the goal is to help you enjoy life, not punish the doctor.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Mar 15, 2013

See another MD for a second opinion.

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Answered by Bella MD Laser Vein and Aesthetic Center

See another MD for a second opinion.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Mar 15, 2013

Get another opinion.

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Answered by General Vascular Surgery Group

Get another opinion.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Mar 15, 2013

It is difficult to answer your question based on the info provided. Did you have reflux? What other symptoms did you have? Did you have swelling before the procedure? Are there other reasons for your symptoms? I would certainly recommend a repeat venous ultrasound to look for persistent reflux or even deep reflux. I would also recommend a second opinion with either a vascular surgeon or a dedicated vein practice physician.

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Answered by Vanish Vein and Laser Center

It is difficult to answer your question based on the info provided. Did you have reflux? What other symptoms did you have? Did you have swelling before the procedure? Are there other reasons for your symptoms? I would certainly recommend a repeat venous ultrasound to look for persistent reflux or even deep reflux. I would also recommend a second opinion with either a vascular surgeon or a dedicated vein practice physician.

Published on Jul 11, 2012


Advanced Vein & Laser Centre, Ltd.

Published on Mar 15, 2013

Get a second opinion.

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Answered by Advanced Vein & Laser Centre, Ltd.

Get a second opinion.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Mar 15, 2013

I would advise you to seek a second opinion from an experienced vascular surgeon who specializes in vein treatment and these procedures. That said, there is no way to know pre-operatively if all the symptoms are caused by saphenous incompetence. In some cases, the swelling persists and you should be evaluated further to see if there is an underlying cause. The aching could be related to the swelling also. I advise you to wear your compression hose, applying them as early in the morning as possible until you get a second opinion. Elevate your legs throughout the day, if possible.

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Answered by Vein Specialties of St. Louis

I would advise you to seek a second opinion from an experienced vascular surgeon who specializes in vein treatment and these procedures. That said, there is no way to know pre-operatively if all the symptoms are caused by saphenous incompetence. In some cases, the swelling persists and you should be evaluated further to see if there is an underlying cause. The aching could be related to the swelling also. I advise you to wear your compression hose, applying them as early in the morning as possible until you get a second opinion. Elevate your legs throughout the day, if possible.

Published on Jul 11, 2012


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