Outcomes with Microphlebectomy/EVLT?

I have dorsal foot varicosities, as well as varicose GSV and LSV's receiving these veins. Has anyone done microphlebectomy of the foot veins (with/out EVLT) and had more good than bad experiences with this procedure here? Thank you!

Answers from doctors (5)


More About Doctor Vein Center for Women PC

Published on Oct 03, 2017

EVLT is a definitive procedure using laser heat delivered to the inner wall of the vein that is causing the reflux in the leg, and closing those veins to stop the reflux causing varicose veins. Your foot veins are part of the pedal arch and drains into these veins, and when these veins are closed they will find alternate routes for connecting to the venous system. I generally recommend to my patients not to touch the foot veins. If there are some vein clusters caused by long standing varicose veins they can be treated later after at least 3-4 weeks after correcting the reflux first. You will be surprised to see the improvement you will see just with correcting reflux with laser or RF or clarivein-any method used to correct reflux.

You may not have to do anything to the foot veins. Generally when foot veins are treated with sclerotherapy, you will see new veins pop up as time goes on. So with regard to foot veins you have to be selective and careful. As I said, most of the time none may be needed or minimal. Patience is needed when you are having varicose veins treated. It may be a few more visits in follow up and may be a few copays more, but you will get much better results waiting to see how your body reroutes the circulation after a vein is closed through other normal veins, and how decreasing venous pressure in the leg after correcting reflux alone makes many of the existing veins appear a lot better. After all, most of the patients had the condition for years and did not seek treatment, but now suddenly you get impatient, you want results overnight.

My advice: do the reflux correcting EVLT first. If it is GSV and SSV do them first. Then wait for a month or two. Then reevaluate for yourself what veins in your foot still appear not normal for you. May be there is a perforator vein which needs to be treated. So go for follow up evaluations with your vein surgeon and follow their recommendation. Thank you for this opportunity.

Answered by Vein Center for Women PC (View Profile)

EVLT is a definitive procedure using laser heat delivered to the inner wall of the vein that is causing the reflux in the leg, and closing those veins to stop the reflux causing varicose veins. Your foot veins are part of the pedal arch and drains into these veins, and when these veins are closed they will find alternate routes for connecting to the venous system. I generally recommend to my patients not to touch the foot veins. If there are some vein clusters caused by long standing varicose veins they can be treated later after at least 3-4 weeks after correcting the reflux first. You will be surprised to see the improvement you will see just with correcting reflux with laser or RF or clarivein-any method used to correct reflux.

You may not have to do anything to the foot veins. Generally when foot veins are treated with sclerotherapy, you will see new veins pop up as time goes on. So with regard to foot veins you have to be selective and careful. As I said, most of the time none may be needed or minimal. Patience is needed when you are having varicose veins treated. It may be a few more visits in follow up and may be a few copays more, but you will get much better results waiting to see how your body reroutes the circulation after a vein is closed through other normal veins, and how decreasing venous pressure in the leg after correcting reflux alone makes many of the existing veins appear a lot better. After all, most of the patients had the condition for years and did not seek treatment, but now suddenly you get impatient, you want results overnight.

My advice: do the reflux correcting EVLT first. If it is GSV and SSV do them first. Then wait for a month or two. Then reevaluate for yourself what veins in your foot still appear not normal for you. May be there is a perforator vein which needs to be treated. So go for follow up evaluations with your vein surgeon and follow their recommendation. Thank you for this opportunity.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Jan 10, 2012

If GSV refluxing it needs to be fixed first.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/772_1408044077.jpg
Answered by Bella MD Laser Vein and Aesthetic Center

If GSV refluxing it needs to be fixed first.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Jan 10, 2012

Not recommended. One should treat the source veins first or simultaneously with the microphlebectomies.

It's important to treat the underlying problem first.

Michael D. Ingegno

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/922_1408044082.jpg
Answered by General Vascular Surgery Group

Not recommended. One should treat the source veins first or simultaneously with the microphlebectomies.

It's important to treat the underlying problem first.

Michael D. Ingegno

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Jan 10, 2012

Firstly you should have a full evaluation with ultrasound to assess if there is underlying reflux in the saphenous veins and a patent deep system. If there is, then EVLT is the appropriate treatment to seal the saphenous veins. I typically do one vein per setting to allow to the leg to recover. I will, however do phlebectomies at the same setting. Bulging dorsal foot veins may shrink after the sealing of the refluxing (back flow) saphenous veins. Statistically 50% may but not always. These can be treated later by phlebectomy if causing discomfort in the shoes etc. These should be done by an experienced surgeon as there are a lot more nerves in the area. I also do many of these cosmetically for patients who don't like the appearance of large veins over the feet. I only do half the foot per treatment.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/623_1499902138.jpg
Answered by Vein Specialties of St. Louis

Firstly you should have a full evaluation with ultrasound to assess if there is underlying reflux in the saphenous veins and a patent deep system. If there is, then EVLT is the appropriate treatment to seal the saphenous veins. I typically do one vein per setting to allow to the leg to recover. I will, however do phlebectomies at the same setting. Bulging dorsal foot veins may shrink after the sealing of the refluxing (back flow) saphenous veins. Statistically 50% may but not always. These can be treated later by phlebectomy if causing discomfort in the shoes etc. These should be done by an experienced surgeon as there are a lot more nerves in the area. I also do many of these cosmetically for patients who don't like the appearance of large veins over the feet. I only do half the foot per treatment.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Jun 08, 2011

I have treated dorsal foot veins frequently with both microphlebectomies and sclerotherapy with excellent results. Sometimes it is done in association with a closure procedure and sometimes independent of a closure procedure.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1053_1499982262.jpg
Answered by Vanish Vein and Laser Center

I have treated dorsal foot veins frequently with both microphlebectomies and sclerotherapy with excellent results. Sometimes it is done in association with a closure procedure and sometimes independent of a closure procedure.

Published on Jul 11, 2012


Related Questions for Endovenous Laser Ablation

Endovenous Laser Ablation -10 answers
I had EVLT about 10 days ago , now I have a big knot on my inner thigh and when I touch it, it still hurts , I had a lot of pain the day after the surgery and I couldn't bend my leg. Is this normal?
See More
Endovenous Laser Ablation -8 answers
If I have had large vessels such as the saphenous closed, is there chance of circulatory problems later on?
See More
Endovenous Laser Ablation -9 answers
Can you please detail some of the restrictions after EVLT?
See More
Endovenous Laser Ablation -10 answers
I am just over 2 weeks post EVLT and still have pain. As long as I take an anti-inflammatory the pain subsides. Visually the inner thigh looks good. How much longer will the pain last?
See More
Endovenous Laser Ablation -8 answers
It has been a week since my EVLT procedure, and I am wondering if I should continue wearing the compression stocking?
See More
Endovenous Laser Ablation -11 answers
I had swelling in my left foot and my doctor confirmed that the valves in two of my veins were not working properly. I had these veins closed with endovenous laser ablation, but four weeks later I still have swelling in my foot that doesn't go away. Is this normal?
See More
Endovenous Laser Ablation -10 answers
I have burning pain at my incision site 3 weeks after endovenous laser ablation. It isn't constant, just when it is touched or rubbed. Could this be nerve damage or a hair follicle that is irritated from the incision?
See More
Endovenous Laser Ablation -6 answers
I had endovenous laser treatment and sclerotherapy performed on both the greater and lessor saphenous veins of my legs. It was done on the same day. After a couple of weeks I started feeling numbness and tingling in my legs, mostly below the knee and through my feet. Will the feelings ever go away?
See More
Get answers from our experienced doctors.
How it works
Endovenous Laser Ablation -6 answers
Or does the treatment permanently remove them?
See More
Endovenous Laser Ablation -5 answers
I had EVLT done about three months ago..right after the EVLT procedure i started feeling weird sensations in my ankle and now the pain seems to get worse every day? Could this pain be associated with the procedure?
See More
Endovenous Laser Ablation -6 answers
I am about two months into treatment for chronic venous insufficiency? I have had laser ablation and foam sclerotherapy with very little results. Can anything be done to treat lipodermatosclerosis after the veins are treated. I wear compression hose.
See More
Endovenous Laser Ablation -13 answers
I had my GSV ablation done 13 days ago and still have intense pain in a segment on the inner thigh just above the knee. Is this level of pain normal and, if so, for how long? I have to take Advil for relief, but my stomach is sensitive to NSAIDS.
See More
Endovenous Laser Ablation -9 answers
I've heard that ELA can result in deep vein thrombosis. Is this true, and how common is this complication? Is there any way to prevent it?
See More
Endovenous Laser Ablation -7 answers
EVLT 5 days ago GSV. No serious pain yet. Compression stocking to come off tomorrow, but bruising seems excessive with dark patches and tenderness to touch. I was told to use heating pad, and now I'm reading not to do that. What should I do?
See More
Endovenous Laser Ablation -5 answers
What are the side effects of drinking alcohol after my evla?
See More
Endovenous Laser Ablation -4 answers
I have sharp stabbing pains in my leg. It's very painful and the Motrin did not help. I was in tears! This went on for a couple of days. The pain is on my right leg and my left leg isn't painful at all. What could this be?
See More
Endovenous Laser Ablation -10 answers
It's been a year since my surgery and I still have bruising. Does that mean it's permanent?
See More
Endovenous Laser Ablation -12 answers
Does this procedure hurt?
See More
Get answers from our experienced doctors.
How it works

Related Articles

Have specific questions?
ASK A DOCTOR