Should I have the Venefit procedure if I don't have varicose veins?

I am 30 years old and a vascular surgeon recently diagnosed me with CVI. I don't have any visible varicose veins yet, but I have had lots of pain and swelling in my lower legs for several years. Should I have VNUS or wait until I get varicose veins?

Answers from doctors (10)


More About Doctor David Green, MD

Published on Jan 07, 2022

CVI is quantifiable, or measurable. If you do not have any skin changes of CVI (discoloration, redness, dermatoliposclerosis, ulceration, atrophie blanche) and no apparent Varicose Veins, you should know what is the size of the 'insufficient' Saphenous Veins (usually 4mm or smaller considered normal) and degree of venous reflux is present (0.5 seconds or 500 milliseconds or less is considered normal). It is always wise to get a second or third opinion from other specialists who are reputable and highly recommended.

Answered by David Green, MD (View Profile)

CVI is quantifiable, or measurable. If you do not have any skin changes of CVI (discoloration, redness, dermatoliposclerosis, ulceration, atrophie blanche) and no apparent Varicose Veins, you should know what is the size of the 'insufficient' Saphenous Veins (usually 4mm or smaller considered normal) and degree of venous reflux is present (0.5 seconds or 500 milliseconds or less is considered normal). It is always wise to get a second or third opinion from other specialists who are reputable and highly recommended.

Published on Jul 11, 2012


Modern Vein & Laser Center

Published on Sep 17, 2017

Pain and swelling in the legs is a significant problem to justify the procedure. No need to wait for the appearance of varicose veins. They may never appear. Varicose veins are another symptom of CVI. Many more exist. We do not have to wait for all.

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Answered by Modern Vein & Laser Center

Pain and swelling in the legs is a significant problem to justify the procedure. No need to wait for the appearance of varicose veins. They may never appear. Varicose veins are another symptom of CVI. Many more exist. We do not have to wait for all.

Published on Jul 11, 2012


NE Laser Vein Institute LLC

Published on Aug 19, 2017

Please get a second opinion. It will help you decide

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Answered by NE Laser Vein Institute LLC

Please get a second opinion. It will help you decide

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Aug 17, 2017

Not everyone with CVI has superficial varicose veins, but they can have a lot of symptoms. You are definitely a candidate for ablation—either radiofrequency or laser. I prefer laser in my practice. In some instances, insurance plans will not cover treatment if there are no varicose veins present. I would have your surgeon appeal this decision if it occurs.

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Answered by Vein Specialties of St. Louis

Not everyone with CVI has superficial varicose veins, but they can have a lot of symptoms. You are definitely a candidate for ablation—either radiofrequency or laser. I prefer laser in my practice. In some instances, insurance plans will not cover treatment if there are no varicose veins present. I would have your surgeon appeal this decision if it occurs.

Published on Jul 11, 2012


Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

Published on Aug 16, 2017

Venous insufficiency can occur with or without tributary varicosities. Untreated venous insufficiency will eventually cause the formation of varicose veins. If you have symptoms, I recommend that you proceed with the procedure if compression stockings fail to relieve your symptoms.

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Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI , RPhS

Venous insufficiency can occur with or without tributary varicosities. Untreated venous insufficiency will eventually cause the formation of varicose veins. If you have symptoms, I recommend that you proceed with the procedure if compression stockings fail to relieve your symptoms.

Published on Jul 11, 2012


Lone Star Vein Center

Published on May 05, 2014

Great question. Your provider may have explained that varicose veins are not always readily visible with the naked eye. In other words, varicose veins may be appreciated through an ultrasound study. Regardless, this
usually presents as a later manifestation of the disease and should not be a major factor of your decision to pursue treatment. I would focus more on treating your pain and swelling, rather than what your legs look like.

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Answered by Lone Star Vein Center

Great question. Your provider may have explained that varicose veins are not always readily visible with the naked eye. In other words, varicose veins may be appreciated through an ultrasound study. Regardless, this
usually presents as a later manifestation of the disease and should not be a major factor of your decision to pursue treatment. I would focus more on treating your pain and swelling, rather than what your legs look like.

Published on Jul 11, 2012


Finesse Surgical Solutions

Published on May 05, 2014

The swelling is probably not due to GSV incompetence, and VNUS is unlikely to change it. Truncal ablation may occasionally be indicated in the absence of varices, depending on individual circumstances.

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Answered by Finesse Surgical Solutions

The swelling is probably not due to GSV incompetence, and VNUS is unlikely to change it. Truncal ablation may occasionally be indicated in the absence of varices, depending on individual circumstances.

Published on Jul 11, 2012


Vein Center of Orange County

Published on May 03, 2014

You don't specify the source of your CVI, but if your doctor has diagnosed CVI by duplex ultrasound and thinks the VNUS procedure will yield symptomatic improvement which you would welcome, then proceed with thermal ablation. I see very few patients who have symptoms of CVI due to superficial veins without surface varicosities as you describe, but when it does occur, treatment is usually successful. If there is any doubt, you can always get a second opinion before proceeding.

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Answered by Vein Center of Orange County

You don't specify the source of your CVI, but if your doctor has diagnosed CVI by duplex ultrasound and thinks the VNUS procedure will yield symptomatic improvement which you would welcome, then proceed with thermal ablation. I see very few patients who have symptoms of CVI due to superficial veins without surface varicosities as you describe, but when it does occur, treatment is usually successful. If there is any doubt, you can always get a second opinion before proceeding.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on May 02, 2014

If you have reflux and symptoms related to the reflux, then you would benefit from a closure procedure (Venefit or any other closure procedure). You do not have to have varicose veins to be eligible for valve closure. CVI is an indication for closure.

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Answered by Vanish Vein and Laser Center

If you have reflux and symptoms related to the reflux, then you would benefit from a closure procedure (Venefit or any other closure procedure). You do not have to have varicose veins to be eligible for valve closure. CVI is an indication for closure.

Published on Jul 11, 2012


Daniels Vein and Cosmetic Center

Published on May 02, 2014

I haven't seen or examined you, but from what you are describing, you may be an excellent candidate for the Venefit procedure. It may help your pain and swelling significantly.

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Answered by Daniels Vein and Cosmetic Center

I haven't seen or examined you, but from what you are describing, you may be an excellent candidate for the Venefit procedure. It may help your pain and swelling significantly.

Published on Jul 11, 2012


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