I hope by "surgery" you mean endothermal ablation, which is an outpatient, well tolerated procedure used to close your saphenous veins. It will help, and you should have it done. We cannot close the deep veins, as you note, but your leg will still feel much better after the superficial veins are closed.

Published on Jul 11, 2012

The majority of your symptoms are coming from the superficial veins and can easily be dealt with ablation. Taking care of the majority of the problem will be better than not addressing any of it and we have seen cases where after the superficial vein is closed, the deep vein reflux lessens or is eliminated.

Published on Jul 11, 2012

People with superficial reflux (saphenous vein) and deep reflux (femoral
vein) can have improvement in symptoms with treating the saphenous vein
because the overall amount of reflux has diminished. If you have significant
deep reflux compression hose for life is still the recommendation.

Published on Jul 11, 2012

Surgery may help...

Studies have shown that treating superficial venous disease often improves and in some instances reverses flow in diseased deep veins such as the femoral vein. Not knowing your ultrasound findings, if only a segment of the deep system is 'leaking', you have a greater than 50% chance of normalizing your deep system. If you have previously had an extensive deep vein clot, you are likely to have continued backwards flow in the deep system.

Simply stated, as long as there are no obstructive findings on your ultrasound, the options are to treat the superficial disease, e.g. endovenous laser for the saphenous veins OR wear fitted compression stockings until you are ready to treat.

It is true that you may not see improvement in your deep system, yet at present there are no effective treatment options for your diseased femoral vein. As a result, if you have a qualified vein specialist experienced in superficial and deep vein pathology, you would likely have the best care with thermal ablation of your diseased saphenous veins.

Good luck

Published on Jul 11, 2012

When both sets of veins (deep and superficial) are leaking one much
determine which is contributing more to the problem. This can be done by
stratifying the insufficiency by the number of seconds one can force the
blood to reflux toward the feet. One can also compare the velocity of the
reflux with the valsava maneuver and thereby determine whether the deep or
superficial vein is the worst one. 95% of the time the superficial veins
are the problem and in the case of mixed deep and superficial insufficiency
closing the severely leaking saphenous vein(great, small, anterior or
other.) usually improves the condition and symptoms.

Published on Jul 11, 2012

I would discuss this very good question with your physcian. If you are not satisfied with his answers or communication then I suggest another opinion.

David A. Engleman M.D.

Published on Jul 11, 2012

It is very common to see reflux in the common femoral vein with reflux of the greater saphenous vein because the terminal valve of the GSV is incompetent. In these cases, the common femoral vein reflux resolves after treatment of the GSV. If you have deep femoral vein reflux in addition to GSV reflux, it has been shown that patient's symptoms will improve with GSV treatment. However, the usually will not completely resolve.

Published on Jul 11, 2012

The saphenous veins are superficial veins and the femoral veins is a deep vein. Reflux in each vein causes different symptoms. Superficial reflux can lead to varicose veins, leg aching, cramping, heaviness, tiredness and even restless legs. Deep reflux may cause no symptoms at all or can lead to swelling and ultimately venous insufficiency(Brownish discoloration of the leg). Usually superficial reflux is treated by Closure if indicated and deep reflux by stockings. Your treatment should be dependent on your symptoms.

Published on Jul 11, 2012