What are my risks with EVLA if I have a protein S deficiency?

I'm 42 years old but had a deep vein thrombosis (DVT) at age 9. I've had no others since, but have some unsightly veins and edema if I walk/run over a few miles. It also happens sometimes when I am sleeping. I'm a mom of 11-yr old triplets, so even a slight risk scares me. What are the risks with this procedure and are there any particular risks if I have a protein S deficiency?

Answers from doctors (11)


Vein Specialties of St. Louis

Published on Nov 01, 2018

If saphenous vein reflux is causing your problem, your surgeon needs to know if you have homozygous Protein S. You will need to be on Lovenox before and after your procedure, but if heterozygous most likely not. You should discuss this with your vascular surgeon and primary care or hematologist before proceeding. In experienced hands, there is no reason not to proceed.

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

If saphenous vein reflux is causing your problem, your surgeon needs to know if you have homozygous Protein S. You will need to be on Lovenox before and after your procedure, but if heterozygous most likely not. You should discuss this with your vascular surgeon and primary care or hematologist before proceeding. In experienced hands, there is no reason not to proceed.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on Apr 30, 2013

Because you have a protein S deficiency, there is a higher risk of deep vein thrombosis (DVT) with endovenous laser treatment.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/713_1408044075.jpg
Answered by Americas Vein Centers - Southborough

Because you have a protein S deficiency, there is a higher risk of deep vein thrombosis (DVT) with endovenous laser treatment.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Apr 23, 2013

Studies have shown patients with protein S deficiency have minimal risk of thrombosis after endovenous laser ablation, assuming you have anticoagulant prophylaxis as part of the procedure.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1015_1408044084.jpg
Answered by Vein Center of Orange County

Studies have shown patients with protein S deficiency have minimal risk of thrombosis after endovenous laser ablation, assuming you have anticoagulant prophylaxis as part of the procedure.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Apr 18, 2013

There is probably just as much risk if you don't have the procedure done. Having reflux in the saphenous veins puts increased pressure on the deep veins which, with time, could corrupt those veins and increase your risk of DVT. The risk of having a deep vein thrombosis after that procedure is very low. Find an interventional radiologist to do the procedure. You can consult with him/her before to describe your concerns.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1153_1408044089.jpg
Answered by Intermountain Vein Center

There is probably just as much risk if you don't have the procedure done. Having reflux in the saphenous veins puts increased pressure on the deep veins which, with time, could corrupt those veins and increase your risk of DVT. The risk of having a deep vein thrombosis after that procedure is very low. Find an interventional radiologist to do the procedure. You can consult with him/her before to describe your concerns.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Apr 17, 2013

Clotting disorders are not a contraindication for endovenous laser ablation (EVLA).







//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/554_1447800116.jpg
Answered by Cosmetic Vein Centers of Texas

Clotting disorders are not a contraindication for endovenous laser ablation (EVLA).







Published on Jul 11, 2012


Arizona Vein Specialists

Published on Apr 16, 2013

Patients with coagulopathy can be treated after proper evaluation and by using Lovanox, a blood thinner injection.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1365_1408044094.jpg
Answered by Arizona Vein Specialists

Patients with coagulopathy can be treated after proper evaluation and by using Lovanox, a blood thinner injection.

Published on Jul 11, 2012


Advanced Vein Center

Published on Apr 16, 2013

You have a 2-11 fold increased risk of DVT. You should definitely talk to the doctor who will be treating you. Most likely you would be anticoagulated for the procedure.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/464_1408044069.jpg
Answered by Advanced Vein Center

You have a 2-11 fold increased risk of DVT. You should definitely talk to the doctor who will be treating you. Most likely you would be anticoagulated for the procedure.

Published on Jul 11, 2012


Vein 911

Published on Apr 15, 2013

Your venous disease can be treated with endovenous laser ablation (EVLA) and foam sclerotherapy. There is little risk if you are fully anticoagulated. The risks associated with untreated venous disease includes: dep vein thrombosis, pulmonary embolism, lifestyle limiting symptoms in your legs, and possible development of ulcers. Consult with a hematologist and find an experienced vein surgeon who will not only help you weigh the risks/options, but will work with your hematologist to ensure the best outcome.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1449_1408044096.jpg
Answered by Vein 911

Your venous disease can be treated with endovenous laser ablation (EVLA) and foam sclerotherapy. There is little risk if you are fully anticoagulated. The risks associated with untreated venous disease includes: dep vein thrombosis, pulmonary embolism, lifestyle limiting symptoms in your legs, and possible development of ulcers. Consult with a hematologist and find an experienced vein surgeon who will not only help you weigh the risks/options, but will work with your hematologist to ensure the best outcome.

Published on Jul 11, 2012


General Vascular Surgery Group

Published on Apr 15, 2013

There is an increased risk of blood clots after the procedure. In my opinion, you should see a hematologist so that your particular risks can be assessed. Additionally, he/she can make recommendations to reduce those risks. That said, I have performed procedures on many patients with hypercoaguable disorders - an appropriate amount of caution should be taken. Note that edema may be due to deep venous valvular insufficiency if you've had a prior DVT, and this would not be changed by a laser ablation. Consult with an experienced vein specialist.

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

There is an increased risk of blood clots after the procedure. In my opinion, you should see a hematologist so that your particular risks can be assessed. Additionally, he/she can make recommendations to reduce those risks. That said, I have performed procedures on many patients with hypercoaguable disorders - an appropriate amount of caution should be taken. Note that edema may be due to deep venous valvular insufficiency if you've had a prior DVT, and this would not be changed by a laser ablation. Consult with an experienced vein specialist.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Apr 15, 2013

The average endovenous laser ablation procedure carries a small risk of DVT (about 1 in 1,000). With protein S deficiency, that risk would be at least 10-40 times greater. You should consult with a qualified vein specialist and hematologist to discuss how the procedure can be accomplished with the least amount of risks.

Answered by Laser Vein Center (View Profile)

The average endovenous laser ablation procedure carries a small risk of DVT (about 1 in 1,000). With protein S deficiency, that risk would be at least 10-40 times greater. You should consult with a qualified vein specialist and hematologist to discuss how the procedure can be accomplished with the least amount of risks.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Apr 15, 2013

Protein S deficiency places you in a higher risk category for a clotting problem post-ablation. You may want to consult with a hematologist before undergoing an elective procedure. Probably, using something like Lovenox the day before and several days after may be prudent.

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

Protein S deficiency places you in a higher risk category for a clotting problem post-ablation. You may want to consult with a hematologist before undergoing an elective procedure. Probably, using something like Lovenox the day before and several days after may be prudent.

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