I am a very active 37-year-old female. I am having bilateral endovenous laser ablation of my saphenous veins. Will my other bulging veins disappear as well? Or, will I need further treatment to remove them later?
Your bulging veins will not go away. No abnormal veins go away without intervention. The doc doing your laser procedure should also address not just your bulging veins but also all of your spiders and reticular veins. Failure to address all aspects of your vein disease can result in treatment failure. If your doc is not offering or is unable to address all parts of your abnormal vein structure, your really need to find someone who can.
Published on Jul 11, 2012
If the bulging veins are connected to those saphenous veins being ablated, then it is possible that you may not have to remove them later. It is not a guarantee, but is possible. That is why the ablations are done first because sometimes it does prevent further treatment.
Published on Jul 11, 2012
All depends if you have other "sources of reflux" for those bulging veins. In one out to five patients all, if not most, bulging veins resolve by ablating the great saphenous vein. But, often times, it is necessary to eliminate other sources of reflux like perforators and small saphenous veins.
Published on Jul 11, 2012
I find it hard to believe your doctor did not discuss this with you. I would seek a second opinion from a board-certified vein specialist who will give you the time you deserve to explain these issues, and maybe think twice about who will be managing your post-procedure care. That being said, only the invisible saphenous veins will shrink immediately or soon after EVLT. The visible varicosities will slowly shrink only if they are being fed by that saphenous trunk. If more than one vein is feeding into them, they will require further treatment in the method of sclerotherapy or phlebectomy.
Published on Jul 11, 2012
You may need further treatment if the varicose veins do not shrink.
Published on Jul 11, 2012
It depends on the anatomy of your blood supply.
Published on Jul 11, 2012
As a surgeon and for my patients best interest, I typically will do the ablation and microphlebectomies (small punctures through which bulging veins are removed) in the same setting. This reduces the cost and number of procedures you need. Statistically, approximately 50% of bulging veins MAY shrink down, but remaining veins would need to be removed at a later date. I do not inject larger varicose veins because it entails many visits for the patient and is now rarely covered by insurance. I have found my patients are far happier seeing the varicose veins gone after the initial procedure.
Published on Jul 11, 2012
It's difficult to say because every patient is different. I would wait for one month after the procedure and reassess. If there are any remaining leaky/dilated veins, I'd either perform ambulatory phlebectomy or ultrasound-guided chemical ablation on those vessels.
Published on Jul 11, 2012
The other bulging veins may get smaller, but will not go away without treatment; therefore, additional treatment will be needed. In our office, we use compression sclerotherapy for remaining veins.
Published on Jul 11, 2012
Not entirely. Once the problematic saphenous veins are treated, the other bulging veins will get smaller and about 20% will disappear, However, the remaining 80% will require additional treatment to make them go away.
Published on Jul 11, 2012
Good question! That depends on the approach your doctor takes. Many physicians simultaneously treat both the visible surface varicosities deriving from the underlying saphenous vein as well as the saphenous vein
itself, which usually eliminates all unwanted veins in one visit. Other physicians take a more conservative approach and wait a month or two after ablation to see if treating just the saphenous vein causes the surface
varicosities to shrink. In my 25 years of experience, most surface veins will not go completely away and end up requiring additional treatment, thereby justifying the all-inclusive first approach.
Published on Jul 11, 2012
Sometimes the bulging veins will resolve over time (about 30%), but usually these bulging veins require additional treatment such as microphlebectomies or sclerotherapy. I usually perform microphlebectomies at the time of the laser ablation so that at the completion of the procedure, all veins are gone.
Published on Jul 11, 2012