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?
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
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
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
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
Clotting disorders are not a contraindication for endovenous laser ablation (EVLA).
Published on Jul 11, 2012
Patients with coagulopathy can be treated after proper evaluation and by using Lovanox, a blood thinner injection.
Published on Jul 11, 2012
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
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
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
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
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