My leg feels a lot better after 2 months (not perfect) but some bulging veins remain. Could I worsen my condition if I don't remove the bulging veins? How would blood flow out?
If you have Varicose Veins, you should consider having them treated by Sclerotherapy, which - when done properly - should result in their more successful and complete removal than Microphlebectomy, which only is able to remove partial segments of targeted varicose veins.
Published on Jul 11, 2012
Not necessary
It all depends on size of varicose vein and whether they are symptomatic or no
Published on Jul 11, 2012
We usually do this at the time of the EVLT, but it is safe to do it as a staged procedure. There are plenty of veins left, including your deeper veins and these varicose veins are safe to remove.
Published on Jul 11, 2012
Phlebectomy is safe with or without ablation. The veins that matter are the deep veins that you cannot see.
Published on Jul 11, 2012
If after 2 month of the EVLT you still have some bulging veins, then you need to complete the treatment to eliminate all the abnormal veins. Microphlebectomy is an option, ultrasound-guided sclerotherapy is another option.
Published on Jul 11, 2012
There is no danger in leaving the residual varicose veins after closure
procedure. I usually wait a month or so before I decide to perform a
microphlebectomy as many of the varicose veins will decompress enough post
endovenous closure that removal is unnecessary in as many as 50% of
patients. Removal indicates in patients with residual pain or
discomfort from the veins or unattractive appearance of the veins. However,
there is not a "medical reason" per se to remove the veins. The remaining
bulging veins are essentially useless and perform no constructive function,
as in returning blood from the legs. This job is done by the deep set of
veins within the muscles.
Published on Jul 11, 2012
Residual bulging veins eventually will become a problem and usually should be treated with microphlebectomy and/or foam sclerotherapy. The venous outflow from the legs already is going through the more normal other veins in the leg.
Published on Jul 11, 2012
If the bulging veins don't bother you, you can leave them alone.
Published on Jul 11, 2012
There are minimal risks performing microphlebectomy after a closure procedure. I, as a surgeon, usually do this procedure at the time of ablation of the saphenous vein. In theory 50% of varicose veins COULD resolve but that leave 50% or more which don't.
It is more convenient and cost effective for my patients also - one down time also. If the veins are not causing in pain or other symptoms and you are not bothered by the appearance, there is no medical reason to remove them. However, cosmetically, your legs would look better. Your circulation has adapted to having non functioning veins and any blood in those varicose veins will be redirected to healthy veins.
Published on Jul 11, 2012
There is no RISK in not doing microstab phlebectomies either during or after a venous closure procedure. It is possible that the bulging varicose veins you are referring to are (or were) fed by vein(s) that was closed - whether that vein be the Greater Saphenous Vein, the Lesser Saphenous Vein, etc. In all events, it is possible that the varicose veins may diminish to some degree but it is unlikely that they will vanish completely as the venous system is quite tenacious and resourceful and very often, when the source of a varicose vein is terminated or closed off, that varicosity will reroute and find another blood source. The best solution for eradicating varicose veins completely is to remove them via microstab phlebectomies.
Published on Jul 11, 2012
There is no added risk to leaving the varicose veins following closure. The same risks of any varicose veins will remain-potential to clot, bleed or worsen with time in addition to their unsightly appearance. Clotting and bleeding are certainly low potential. It seems to me that if you underwent the closure procedure, you should complete the process and get rid of the varicose veins. Microphlebectomies are usually a lesser procedure then closure. There are plenty of additional veins in your leg to return the flow.
Published on Jul 11, 2012