I had vein stripping and endovenous laser ablation to get rid of my varicose veins, but both have failed to produce results. I've seen a cardiology doctor and had an ultrasound and vein mapping test. My doctor suggested 2 more treatments on the left leg to resolve the vein swelling and lower redness. I'm very disappointed with the results of the ELA procedure. I've experienced in 11/12 no changes. Why is this?
If you are continuing to have problems, it would indicate that either the treated vein did not close off or another vein started having problems with reflux. You could also have some perforator veins that are contributing to the problems There is a small recurrence rate for varicose veins (somewhere in the neighborhood of 15%). An examination from an experienced vascular clinic should provide you with answers and a plan of treatment. If you want your problems with your veins to resolve, I would recommend you seek further treatment.
Published on Jul 11, 2012
Let me explain a little bit about how venous insufficiency and varicose veins works.
1. You need a complete work up, including medical history, physical examination and
complete venous mapping of veins before any procedure
2. After each procedure, you need a follow-up ultrasound, not only to find out about how the success of the procedure but also how the procedure effected the dynamic of the veins. Sometime after the procedure, other accessory veins get closed also, or sometimes perforator veins will show up. If this is the case, further treatments may be needed.
3. Try to talk to your vein doctor and have him explain what's going on at the time of the ultrasound.
Hope this helps!
Published on Jul 11, 2012
If you have had numerous procedures but still see no improvement, it is time for another evaluation. Make sure that the physician you are seeing is knowledgeable and skilled in a variety of treatment modalities. He/she should also be accredited/board certified. Finding someone who possesses the necessary education, skill set, and certification will better ensure that your treatment is carried out appropriately. This will mean fewer complications and better results.
Published on Jul 11, 2012
It is a little difficult to answer that question without seeing an ultrasound report. It sounds like there is still more treatment that needs to be done because one ablation and taking out the bulging veins may not be all that is needed to resolve your venous issues. I would recommend going to an interventional radiologist for another ultrasound and treatment. Make sure the IR is accredited by the American College of Phlebology.
Published on Jul 11, 2012
Sorry, but it is hard to determine why you've had no significant improvement without an exam and ultrasound info. Some people's venous reflux is more complicated than just a simple fix with closure of GSV.
Published on Jul 11, 2012
It sounds as if you have chronic venous insufficiency. In some people there will be ongoing issues, new veins developing and persistent symptoms. This can occur in the most experienced surgical hands. Additionally, not all lower leg swelling and discoloration is caused by venous insufficiency. There is no definite way to know this before proceeding. I always explain to my patients that, in my experience, most of these symptoms are produced by their insufficiency. However, there is always a possibility there is some other underlying cause. There are additional veins that can contribute to your symptoms. including the short saphenous vein, accessory saphenous vein and many communicating veins. Get evaluated for the edema. In the meantime, reduce your salt intake, lose weight if needed, and wear a measured and fitted compression sock or suitable medical grade.
Published on Jul 11, 2012
Your first problem is that you went to a cardiologist. He/she specializes in the heart, not veins. They do it as a sideline. You really should have gone to someone who specializes only in vein treatments. That said, your problem is that your doc only did part of your treatment. Your vein structure is a 3D network that extends from deep in the leg all the way to the skin and from top down. Your doc probably only treated 5% of what you have. In order to generate the result you are probably looking for, you need to address all aspects of your vein structure, not just doing a laser and stripping a few veins out. Unless we get a look at your legs, it is very difficult to say what needs to be done to fix them. Seek a second opinion from an accredited and qualified vascular surgeon.
Published on Jul 11, 2012
By what you report, you still have refluxing valves that could be contributing to your problem. One of the main principles in treating venous insufficiency is to close all open valves. This will reduce and improve symptoms. However, swelling and skin changes (redness) are signs of chronic venous insufficiency, and closure procedures may not resolve this. The goal of the closure procedure is to prevent venous insufficiency from worsening. It may not necessarily reverse the symptoms that are already present. You may want to see an accredited vein specialist who has the experience and skill to treat your condition.
Published on Jul 11, 2012
You most likely still have some remnant tributaries and perforator branches that are secondary sources of venous reflux. These branches need to be treated individually with ultrasound-guided foam sclerotherapy. Make sure that your practitioner is well experienced in this technique since treatment could be counterproductive in the hands of inexperienced practitioners.
Published on Jul 11, 2012
It is apparent that whoever treated you did little to educate you on how treatments work, or the venous anatomy. With the available information, it appears you have some residual veins that require additional treatment. There is a source of reflux feeding these veins that has not been shut down. Successful outcome requires identification of this source and eradication. Meanwhile, continue wearing compression stockings.
Published on Jul 11, 2012
Unfortunately, in many cases, vein disease progresses. We can only slow it down or contain it, but we cannot cure it or reverse it. Sorry
Published on Jul 11, 2012