I had a VNUS closure, followed by sclerotherapy, but none of the original spider veins are gone. Why wasn't treatment successful?

I had a VNUS closure April 2013, followed by sclerotherapy. I've noticed clustering and that none of the original spider veins are gone. I can press on them and watch the blood flow return. I wore stockings for 2 weeks & followed all instructions. Why wasn't treatment successful? What should I do now?

Answers from doctors (13)


Intermountain Vein Center

Published on Dec 31, 2013

That doesn't mean the treatment wasn't successful, it just means that those spider veins are separate from your other vein problems. If you want them treated, you just need to have them injected with a sclerosant. Spider veins are considered cosmetic and will not be covered by insurance. Make sure you still see a clinic with a physician who is accredited by the American College of Phlebology.

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Answered by Intermountain Vein Center

That doesn't mean the treatment wasn't successful, it just means that those spider veins are separate from your other vein problems. If you want them treated, you just need to have them injected with a sclerosant. Spider veins are considered cosmetic and will not be covered by insurance. Make sure you still see a clinic with a physician who is accredited by the American College of Phlebology.

Published on Jul 11, 2012


Michael F. Gioscia, MD, FACS, ABVLM

Published on Nov 25, 2013

The presence of spider veins after endoluminal ablation and sclerotherapy does not mean the treatment has failed. You may require additional sessions; you may have developed matting from your treatment, etc. There
are several reasons for the appearance, but you should have a follow-up doppler to determine if there are any larger, remaining veins with reflux prior to continuing treatment.

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Answered by Michael F. Gioscia, MD, FACS, ABVLM

The presence of spider veins after endoluminal ablation and sclerotherapy does not mean the treatment has failed. You may require additional sessions; you may have developed matting from your treatment, etc. There
are several reasons for the appearance, but you should have a follow-up doppler to determine if there are any larger, remaining veins with reflux prior to continuing treatment.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Nov 20, 2013

Merely having a VNUS closure and some sclerotherapy does not always constitute a complete treatment. Proper vein treatments involves a comprehensive treatment of a person's leg veins. This means addressing not just what is abnormal on the inside of the leg, but also all of the spiders and reticular veins present at skin level. Precisely why your treatment was not successful is difficult to tell without properly evaluating your legs to see what is actually going on. Therefore, I recommend you get evaluated by an accredited vein specialist/surgeon who is capable of managing all of your care. He/she should be highly experienced and comfortable performing (successfully) a variety of treatment modalities.

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Answered by The Sheen Vein Institute

Merely having a VNUS closure and some sclerotherapy does not always constitute a complete treatment. Proper vein treatments involves a comprehensive treatment of a person's leg veins. This means addressing not just what is abnormal on the inside of the leg, but also all of the spiders and reticular veins present at skin level. Precisely why your treatment was not successful is difficult to tell without properly evaluating your legs to see what is actually going on. Therefore, I recommend you get evaluated by an accredited vein specialist/surgeon who is capable of managing all of your care. He/she should be highly experienced and comfortable performing (successfully) a variety of treatment modalities.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Nov 19, 2013

Closure procedures seal the major leaking saphenous veins but does not treat spider veins. The sclerotherapy could have been done on either the varicose veins or spider veins, or both. However, sclerotherapy is a process and usually requires multiple treatments to be successful. You most likely need additional sclerotherapy treatments.

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Answered by Vanish Vein and Laser Center

Closure procedures seal the major leaking saphenous veins but does not treat spider veins. The sclerotherapy could have been done on either the varicose veins or spider veins, or both. However, sclerotherapy is a process and usually requires multiple treatments to be successful. You most likely need additional sclerotherapy treatments.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Nov 18, 2013

It usually takes 3-4 sclerotherapy treatments to clear spider veins.

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Answered by Cosmetic Vein Centers of Texas

It usually takes 3-4 sclerotherapy treatments to clear spider veins.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Nov 18, 2013

You should be reevaluated and have another ultrasound examination. You didn't mention how many treatments of sclerotherapy were performed. Typically it can take between 3-5 treatments for an area of veins to resolve, and about 75-80% clearing is considered good. Additionally, the reticular "feeder" veins below an area of spider veins, if present, should also be addressed.

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Answered by Vein Specialties of St. Louis

You should be reevaluated and have another ultrasound examination. You didn't mention how many treatments of sclerotherapy were performed. Typically it can take between 3-5 treatments for an area of veins to resolve, and about 75-80% clearing is considered good. Additionally, the reticular "feeder" veins below an area of spider veins, if present, should also be addressed.

Published on Jul 11, 2012


Heart and Vein Center

Published on Nov 17, 2013

You will need sclerotherapy to eliminate the spider veins.

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Answered by Heart and Vein Center

You will need sclerotherapy to eliminate the spider veins.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Nov 16, 2013

The VNUS closure and even the sclerotherapy may have been successful, and ultrasound would tell this. Spider veins are considered cosmetic and their treatment may not have been covered by insurance. Was the
sclerotherapy cosmetic and used to address the spider veins? Did you receive an adequate number of treatments? It can often take 4 - 6 sclerotherapy treatment to eliminate spider veins. It is possible that the
sclerotherapy was cosmetic, not covered by insurance and done in insufficient number of treatments, but there are a few time when spider veins wont go away.

Answered by Laser Vein Center (View Profile)

The VNUS closure and even the sclerotherapy may have been successful, and ultrasound would tell this. Spider veins are considered cosmetic and their treatment may not have been covered by insurance. Was the
sclerotherapy cosmetic and used to address the spider veins? Did you receive an adequate number of treatments? It can often take 4 - 6 sclerotherapy treatment to eliminate spider veins. It is possible that the
sclerotherapy was cosmetic, not covered by insurance and done in insufficient number of treatments, but there are a few time when spider veins wont go away.

Published on Jul 11, 2012


South Palm Cardiovascular Associates

Published on Nov 16, 2013

VNUS closure procedures should never be proposed to fix spider veins. Spider veins generally require meticulous follow up treatments (usually done every 4 to 6 weeks in several sessions) for thorough treatment of them. Sclerotherapy has various forms, and perhaps they only did sclerotherapy as part of your closure procedure to treat your venous reflux disease. Again, any successful treatment relies on appropriate communication beforehand. Ask your physician why the spider veins persist. If he/she does not give you an answer or if you are not content with the answer, seek a second opinion from a more qualified vein specialist.

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Answered by South Palm Cardiovascular Associates

VNUS closure procedures should never be proposed to fix spider veins. Spider veins generally require meticulous follow up treatments (usually done every 4 to 6 weeks in several sessions) for thorough treatment of them. Sclerotherapy has various forms, and perhaps they only did sclerotherapy as part of your closure procedure to treat your venous reflux disease. Again, any successful treatment relies on appropriate communication beforehand. Ask your physician why the spider veins persist. If he/she does not give you an answer or if you are not content with the answer, seek a second opinion from a more qualified vein specialist.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Nov 15, 2013

Thermal ablation treatment of saphenous veins removes the pressure that causes varicose veins and some spider veins, and is often the first step in vein treatment. However, expert sclerotherapy is often needed afterward to eradicate spider veins. Your results should be discussed with your treating physician.

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Answered by Vein Center of Orange County

Thermal ablation treatment of saphenous veins removes the pressure that causes varicose veins and some spider veins, and is often the first step in vein treatment. However, expert sclerotherapy is often needed afterward to eradicate spider veins. Your results should be discussed with your treating physician.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on Nov 15, 2013

It's difficult to say why your spider vein problem has not resolved; it can be due to a variety of reasons. You need to be reevaluated. If you are not confident in the doctor(s) who performed your treatment, seek a second opinion and treatment from an accredited vein specialist who is qualified/skilled to be in charge of your care.

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Answered by Americas Vein Centers - Southborough

It's difficult to say why your spider vein problem has not resolved; it can be due to a variety of reasons. You need to be reevaluated. If you are not confident in the doctor(s) who performed your treatment, seek a second opinion and treatment from an accredited vein specialist who is qualified/skilled to be in charge of your care.

Published on Jul 11, 2012


Smith Vein Institute, LLC

Published on Nov 15, 2013

Were the spider veins directly treated? When you say that you had sclerotherapy, was that ultrasound guided sclerotherapy of the deeper veins or surface spider vein sclerotherapy? If it was of the deeper veins, then the spider veins will not go away. They must be directly injected.

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Answered by Smith Vein Institute, LLC

Were the spider veins directly treated? When you say that you had sclerotherapy, was that ultrasound guided sclerotherapy of the deeper veins or surface spider vein sclerotherapy? If it was of the deeper veins, then the spider veins will not go away. They must be directly injected.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Nov 15, 2013

Ablation/sclerotherapy addresses larger veins, not spider veins.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

Ablation/sclerotherapy addresses larger veins, not spider veins.

Published on Jul 11, 2012


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