What should be done about veins that reopen or are partially occluded?

I am an active 45 year old who had endovenous laser ablation done on the great saphenous vein and lesser saphenous vein. After 4 months of complications, I had an ultrasound to determine the source. It turns out that the GSV was open at the top and partially occluded near the knee. The LSV was also partially occluded. My treating physician said to wait 6+ mo & reevaluate. I am tired of the pain. What should I do?

Answers from doctors (15)


Americas Vein Centers - Southborough

Published on Nov 07, 2013

Wait six months to see if the problem has improved. If not, you may need sclerotherapy. However, if your pain is not tolerable, you may want to urge your physician to manage it. Should he/she refuse or if his/her recommendations do not suit you, there is always the option of seeking a second opinion.

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Answered by Americas Vein Centers - Southborough

Wait six months to see if the problem has improved. If not, you may need sclerotherapy. However, if your pain is not tolerable, you may want to urge your physician to manage it. Should he/she refuse or if his/her recommendations do not suit you, there is always the option of seeking a second opinion.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Nov 05, 2013

I am sorry for your complications and pain. My advice depends on whether the vein has completely opened up. If this is the case, then re-treatment is in order. However, if the vein is partially occluded, then it is best to wait and re- evaluate.

Answered by Laser Vein Center (View Profile)

I am sorry for your complications and pain. My advice depends on whether the vein has completely opened up. If this is the case, then re-treatment is in order. However, if the vein is partially occluded, then it is best to wait and re- evaluate.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on Oct 30, 2013

You should wear support stockings. Secondly, since you are symptomatic, a good case exists for foam
sclerotherapy and/or endovenous laser treatment again. Make sure to be treated by an experienced vein specialist.

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Answered by Arizona Vein Specialists

You should wear support stockings. Secondly, since you are symptomatic, a good case exists for foam
sclerotherapy and/or endovenous laser treatment again. Make sure to be treated by an experienced vein specialist.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Oct 30, 2013

Usually those types of things can be retreated with sclerotherapy, unless the proximal portion of the GSV is big enough to ablate. Still, sclerotherapy should do the trick. Even with a partially occluded vein, sometimes sclero will close the rest down. The portion of the GSV that is open will most likely remain open until treatment is done. Make sure your physician is accredited by the American College of Phlebology.

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Answered by Intermountain Vein Center

Usually those types of things can be retreated with sclerotherapy, unless the proximal portion of the GSV is big enough to ablate. Still, sclerotherapy should do the trick. Even with a partially occluded vein, sometimes sclero will close the rest down. The portion of the GSV that is open will most likely remain open until treatment is done. Make sure your physician is accredited by the American College of Phlebology.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Oct 29, 2013

A second laser procedure may be needed or, perhaps, ultrasound-guided CO2 foam sclerotherapy can close off the remaining channels in the veins.

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Answered by Cosmetic Vein Centers of Texas

A second laser procedure may be needed or, perhaps, ultrasound-guided CO2 foam sclerotherapy can close off the remaining channels in the veins.

Published on Jul 11, 2012


VeinSolutions - Edina

Published on Oct 29, 2013

If you are having pain and it has been over four months since your procedure, you are still having appreciable pain and your provider is suggesting you wait an additional six months and then reassess, it seems evidently clear you should seek a second opinion. I would suggest a board-certified vascular surgeon.

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Answered by VeinSolutions - Edina

If you are having pain and it has been over four months since your procedure, you are still having appreciable pain and your provider is suggesting you wait an additional six months and then reassess, it seems evidently clear you should seek a second opinion. I would suggest a board-certified vascular surgeon.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Oct 29, 2013

It is very unusual for an lasered saphenous vein to remain partially open after expert ablation by an experienced physician. When it does occur, ultrasound-guided sclerotherapy is a good option to close the remaining open saphenous vein segments as long as there are large incompetent perforator veins. In the absence of thrombosis, the level of your discomfort can dictate whether you decide to wait or proceed with
alternative treatment.

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Answered by Vein Center of Orange County

It is very unusual for an lasered saphenous vein to remain partially open after expert ablation by an experienced physician. When it does occur, ultrasound-guided sclerotherapy is a good option to close the remaining open saphenous vein segments as long as there are large incompetent perforator veins. In the absence of thrombosis, the level of your discomfort can dictate whether you decide to wait or proceed with
alternative treatment.

Published on Jul 11, 2012


Palm Vein Center

Published on Oct 29, 2013

I suggest waiting 2 months after the procedure. By then, your doctor should get a better understanding of your healing process.

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Answered by Palm Vein Center

I suggest waiting 2 months after the procedure. By then, your doctor should get a better understanding of your healing process.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Oct 29, 2013

You need to have your legs re-evaluated and treated. The reason you are having pain is because your treated vessels are still open and you probably also have refluxing side branches that are causing these veins to re-open. All of those side branches, in addition to the saphenous vessels, need to be treated. Closing these vessels down should help to eliminate your symptoms. Give my office a call and let us see what we can do for you.

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Answered by The Sheen Vein Institute

You need to have your legs re-evaluated and treated. The reason you are having pain is because your treated vessels are still open and you probably also have refluxing side branches that are causing these veins to re-open. All of those side branches, in addition to the saphenous vessels, need to be treated. Closing these vessels down should help to eliminate your symptoms. Give my office a call and let us see what we can do for you.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Oct 29, 2013

My recommendation is to seek a second opinion from an experienced vascular surgeon who performs these procedures. You should not be having this level of discomfort at this stage. I highly recommend you continue to wear compression hose in the interim.

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Answered by Vein Specialties of St. Louis

My recommendation is to seek a second opinion from an experienced vascular surgeon who performs these procedures. You should not be having this level of discomfort at this stage. I highly recommend you continue to wear compression hose in the interim.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Oct 28, 2013

A small percentage of veins treated by closure may not close. Usually the percentage is directly related to the volume of closures done by the treating physician. First of all, I would ensure that your pain is not due to something else. Significant pain is usually not a symptom of incomplete closure or recanalization. I would also redo the venous duplex and consider closing anything left open by ultrasound-guided foam sclerotherapy. By 4 months, I doubt that there will be any further closure without intervention.

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Answered by Vanish Vein and Laser Center

A small percentage of veins treated by closure may not close. Usually the percentage is directly related to the volume of closures done by the treating physician. First of all, I would ensure that your pain is not due to something else. Significant pain is usually not a symptom of incomplete closure or recanalization. I would also redo the venous duplex and consider closing anything left open by ultrasound-guided foam sclerotherapy. By 4 months, I doubt that there will be any further closure without intervention.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Oct 28, 2013

About 5% of saphenous veins need to be retreated due to reopening and partial occlusion. If you are not comfortable with waiting six months to be reevaluated or to have treatment, seek a second opinion. Should you choose to go this route, make sure the vein specialist you choose is experienced and accredited/board certified.

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Answered by Bella MD Laser Vein and Aesthetic Center

About 5% of saphenous veins need to be retreated due to reopening and partial occlusion. If you are not comfortable with waiting six months to be reevaluated or to have treatment, seek a second opinion. Should you choose to go this route, make sure the vein specialist you choose is experienced and accredited/board certified.

Published on Jul 11, 2012


Aluna Vein Centers

Published on Oct 28, 2013

Ultrasound-guided foam sclerotherapy (USGFS) can close the rest of the veins. Also, compression stockings should be worn following the treatment to help keep the sclerosant in the veins, which better ensures their closure.

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Answered by Aluna Vein Centers

Ultrasound-guided foam sclerotherapy (USGFS) can close the rest of the veins. Also, compression stockings should be worn following the treatment to help keep the sclerosant in the veins, which better ensures their closure.

Published on Jul 11, 2012


Heart and Vein Center

Published on Oct 28, 2013

Total or partial recanalization (reopening) of veins is not unusual after endovenous laser ablation. If found early, partial recanalization can be treated with ultrasound-guided foam sclerotherapy. If the recanalization is complete, the vein might need to have the endovenous laser treatment done again. Not all practitioners who do endovenous laser have the training and knowledge to do ultrasound-guided foam sclerotherapy. Make sure your doctor has the experience to perform the procedures and the experience to treat this problem after venous laser ablation.

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Answered by Heart and Vein Center

Total or partial recanalization (reopening) of veins is not unusual after endovenous laser ablation. If found early, partial recanalization can be treated with ultrasound-guided foam sclerotherapy. If the recanalization is complete, the vein might need to have the endovenous laser treatment done again. Not all practitioners who do endovenous laser have the training and knowledge to do ultrasound-guided foam sclerotherapy. Make sure your doctor has the experience to perform the procedures and the experience to treat this problem after venous laser ablation.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Oct 28, 2013

If still causing symptoms, there are injection or catheter-based closure procedures.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

If still causing symptoms, there are injection or catheter-based closure procedures.

Published on Jul 11, 2012


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