My first sclerotherapy procedure was 2 years ago, and I have VNUS closure prior. I was happy with the results until now. After my last sclerotherapy procedure 2 months ago, one of my legs looks worse than ever. It suddenly got worse. Why is this happening? What can I do? Help!
It is impossible to comment on this without seeing you, seeing your ultrasound scans, and knowing who treated you and their experience and services provided. For this, I recommend you go back to the physician who treated you and request another examination, or seek a second opinion.
Published on Jul 11, 2012
Is there brown staining, or are more veins prominent under the skin? Was it ultrasound-guided sclerotherapy or spider vein sclero? I would recommend 1st making sure your physician is accredited by the American College of Phlebology and have an ultrasound done on your legs. There could be other sources of venous reflux that will sometimes cause new veins to grow. Veins are weird like that; sometimes people just grow new veins. It's genetic. But finding an accredited physician will make all the difference in the treatment quality and process.
Published on Jul 11, 2012
I am very sorry for this unfortunate occurrence, however this can happen after sclerotherapy. You should discuss your concerns with your doctor.
Published on Jul 11, 2012
I would suggest repeating an ultrasound on that leg to see if anything re-opened, or if you grew new veins. The latter does occur. Does your leg look worse due to more swelling, new spider veins or leg pain? If you had the VNUS closure procedure and visual /surface injections to spider veins and deeper tributaries were not injected with ultrasound guidance, there may be a recurrence of spider veins. With leg pain and/or swelling, I would want to make sure you do not have any blood clots. Blood clots are rare, but possible complication to sclerotherapy. I think re-evaluation in any instance by your provider would be appropriate because it is difficult to assess without seeing your leg and talking to you further about your symptoms.
Published on Jul 11, 2012
By "worse," do you mean discolored? Hyperpigmentation can last for several months (up to 18) and even be permanent. You should ask your doctor if there is any trapped blood in the injected veins that could be aspirated,
since this may help.
Published on Jul 11, 2012
Your problem may be that you need another large superficial vein to be closed. Angiogenesis is present.
Published on Jul 11, 2012
I recommend that you consult with a physician who is certified by the American Board of Venous and Lymphatic Medicine.
Published on Jul 11, 2012
May be due to temporary hyperpigmentation.
Published on Jul 11, 2012
If you spider veins have worsened after sclerotherapy, it might mean that you still have venous insufficiency (a bad vein inside your leg) despite having a closure procedure in the past. A venous ultrasound would answer this question. Other things to keep in mind would include a complication called "matting." After treatment, tiny red veins can grow into the area, which is usually self-limited. If these veins do not disappear, more treatment can clear them. I hope that helps.
Published on Jul 11, 2012
First of all, I would recommend a follow-up venous ultrasound to assess the status of your veins from the treatment 2 years ago. There may be an underlying refluxing vein contributing to the problem. Also, post-sclerotherapy veins usually look worse before better. That said, by 2 months post-treatment, they should be better not worse. Follow up with your treating physician.
Published on Jul 11, 2012
You should get a full evaluation from a board certified vascular surgeon who is experienced in treating superficial venous disease. This surgeon will perform a physical exam and ultrasound. It is possible there is a "feeder" reticular vein, perforator vein or some underlying problem. If this is addressed, it should make superficial problems improve with further treatment. With your history, it sounds like you have a condition called chronic venous insufficiency, and you may have ongoing development of new veins due to this. Additionally, you should only have sclerotherapy treatments by an experienced physician.
Published on Jul 11, 2012
Are you talking visual sclerotherapy? Ultrasound-guided foam sclerotherapy? You need to specify what worse means (e.g., bruising, pain, swelling, etc). Without further detail, it is difficult to answer your questions. I would suggest you return to your treating physician or seek a second opinion. Be sure to have the specifics I mentioned earlier.
Published on Jul 11, 2012