I had sclerotherapy on several reticular veins for the 2nd time about 1 month ago. At times the veins bulge during the day, but other times look flat. Is this part of the healing process or does this mean that the sclerotherapy did not work? Thanks.
When the reticulars are larger they will take longer to resolve if they are sealed. If they feel firm to touch (or like small bumps, lines etc) there may be trapped blood in there. This happens when the vein collapses and there are small pockets of old blood in there. These are best released by your treating sclerotheapist/doctor. It is a quick visit and there shouldn't be a charge. It will speed up healing. Veins can take 3-5 treatments to resolve. Reticulars often seal in less time. There are procedures that involve injection and a combination with interrupting the vein with a small puncture which can be very effective.
Published on Jul 11, 2012
If the veins became large during the day it means there is active flow in those veins and need further treatment.
Published on Jul 11, 2012
A few questions regarding your evaluation. Did you have a thorough venous
insufficiency ultrasound before your sclerotherapy? It sounds like you
might have some underlying insufficiency in the deeper veins so if you have
not had an ultrasound this is the next step. If you have had an ultrasound
you might want to consider a second opinion and another ultrasound. Bulging
in the veins is a pretty good sign of underlying leaky veins connecting to
and causing the reticular veins to be pressurized (and bulge). If the veins
are tender and you can feel a "knot" where the vein was then this is likely
clot and should be drained.
Published on Jul 11, 2012
Generally if the vein is filling and collapsing they are still open, but possibly partially treated. Not all sclerotherapy treatment are 100% sucessful, and commonly repeat injections are required.
Michael D. Ingegno, MD
Published on Jul 11, 2012
Have the treating physician re-evaluate them.
Published on Jul 11, 2012
It is impossible to answer this question without seeing you. Veins can be open and bulge when you stand or clotted from sclero and seem more prominent when you stand. You should follow up with your vein care specialist.
Published on Jul 11, 2012