Why are varicose veins appearing on the back of my leg following endovenous laser ablation of the greater saphenous veins?

I had ELA of the greater saphenous veins 5 months ago. Since then I have seen more varicose veins appearing on the back of my thigh. Ultrasound revealed that the treated vein has not reopened and there is no insufficiency of the short saphenous.What can it be?

Answers from doctors (11)


Aluna Vein Centers

Published on Oct 28, 2013

There are posterior accessory veins that come off of the GSV, and there are perforator veins that come from the deep system. One or both might be insufficient. To determine the source of your developing varicose veins, you need to be reevaluated. Make sure that the vein specialist you choose is not only board certified, but skilled in a number of different modalities.

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Answered by Aluna Vein Centers

There are posterior accessory veins that come off of the GSV, and there are perforator veins that come from the deep system. One or both might be insufficient. To determine the source of your developing varicose veins, you need to be reevaluated. Make sure that the vein specialist you choose is not only board certified, but skilled in a number of different modalities.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Oct 25, 2013

Do you have a vein of Giacomini? It could tie into that vein. You could also have other varices that have reflux that the bulging vein ties in to. The change in blood flow from treating the greater saphenous vein sometimes will allow already damaged veins to become more prominent. A follow-up ultrasound would be a good idea to see if you need some sclerotherapy and ambulatory phlebectomy.

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Answered by Intermountain Vein Center

Do you have a vein of Giacomini? It could tie into that vein. You could also have other varices that have reflux that the bulging vein ties in to. The change in blood flow from treating the greater saphenous vein sometimes will allow already damaged veins to become more prominent. A follow-up ultrasound would be a good idea to see if you need some sclerotherapy and ambulatory phlebectomy.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on Oct 25, 2013

The branch veins are open and need to be evaluated.

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Answered by Americas Vein Centers - Southborough

The branch veins are open and need to be evaluated.

Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Oct 25, 2013

The source of your new varicose veins may lie with the perforator or pelvic.

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Answered by Bella MD Laser Vein and Aesthetic Center

The source of your new varicose veins may lie with the perforator or pelvic.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Oct 25, 2013

When someone has venous insufficiency (CVI) it can be a chronic condition. You should have a thorough ultrasound by an experienced vascular surgeon who will look for perforator veins that communicate from the deeper and superficial veins. The valves in other veins can also fail, such as pudendal, thigh extension of the short saphenous etc. There can be perforator veins in the lateral subdermic system.

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Answered by Vein Specialties of St. Louis

When someone has venous insufficiency (CVI) it can be a chronic condition. You should have a thorough ultrasound by an experienced vascular surgeon who will look for perforator veins that communicate from the deeper and superficial veins. The valves in other veins can also fail, such as pudendal, thigh extension of the short saphenous etc. There can be perforator veins in the lateral subdermic system.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Oct 25, 2013

You have more than one or two veins in your legs. If all that you had done 5 months ago was the endovenous laser ablation, then you effectively only treated may be 5 % of what you have. Remember that your vein structure is like a 3D network from deep in the leg all the way out to the skin and from top down. Treating just 1 or 2 veins will not fix your problem. The varicose veins that you are noticing are just secondary branches that have gone bad or were already bad and just got bigger after the treatment of your GSV redirected blood volume into them. The impression I am getting is that you have probably already gone back to the doc who did your laser and he/she did not have an answer for you. It's because they probably only do vein treatments part-time. Any one who only treats veins would have been able to tell you exactly why you are having this issue. If you would like to find out what needs to be done to fix your legs, seek out an accredited vein specialist who treats veins full-time and who has the knowledge to explain how your vein structure all works and pinpoint the source of your varicose veins so that future treatment is more effective.

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Answered by The Sheen Vein Institute

You have more than one or two veins in your legs. If all that you had done 5 months ago was the endovenous laser ablation, then you effectively only treated may be 5 % of what you have. Remember that your vein structure is like a 3D network from deep in the leg all the way out to the skin and from top down. Treating just 1 or 2 veins will not fix your problem. The varicose veins that you are noticing are just secondary branches that have gone bad or were already bad and just got bigger after the treatment of your GSV redirected blood volume into them. The impression I am getting is that you have probably already gone back to the doc who did your laser and he/she did not have an answer for you. It's because they probably only do vein treatments part-time. Any one who only treats veins would have been able to tell you exactly why you are having this issue. If you would like to find out what needs to be done to fix your legs, seek out an accredited vein specialist who treats veins full-time and who has the knowledge to explain how your vein structure all works and pinpoint the source of your varicose veins so that future treatment is more effective.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Oct 24, 2013

The two most common veins to have reflux resulting in varicose veins are the greater and small saphenous veins. If new varicose veins form and these two veins are closed or do not demonstrate reflux, then another source of the varicose veins needs to be found. It could be the vein of Giacomini in the posterior thigh, a thigh perforator, a pelvic source, or a branch of the treated veins. A thorough ultrasound is mandatory. From experience, I can tell you that if you have varicose veins, then there has to be a source.

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Answered by Vanish Vein and Laser Center

The two most common veins to have reflux resulting in varicose veins are the greater and small saphenous veins. If new varicose veins form and these two veins are closed or do not demonstrate reflux, then another source of the varicose veins needs to be found. It could be the vein of Giacomini in the posterior thigh, a thigh perforator, a pelvic source, or a branch of the treated veins. A thorough ultrasound is mandatory. From experience, I can tell you that if you have varicose veins, then there has to be a source.

Published on Jul 11, 2012


Heart and Vein Center

Published on Oct 24, 2013

It's quite possible you still have tributaries and perforator branches that need to be treated individually with ultrasound-guided foam sclerotherapy.

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Answered by Heart and Vein Center

It's quite possible you still have tributaries and perforator branches that need to be treated individually with ultrasound-guided foam sclerotherapy.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on Oct 24, 2013

It can be due to an incompetent perforator vein in the thigh. Return to your treating physician for an ultrasound. The imaging test should reveal the source of your varicose veins. Keep in mind that further treatment may be needed to resolve all of your vein issues. ELA alone usually does not fix everything.

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Answered by Arizona Vein Specialists

It can be due to an incompetent perforator vein in the thigh. Return to your treating physician for an ultrasound. The imaging test should reveal the source of your varicose veins. Keep in mind that further treatment may be needed to resolve all of your vein issues. ELA alone usually does not fix everything.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Oct 24, 2013

If the great saphenous vein is closed and the small ("short") saphenous vein is normal, then the new vein must have a different source and is part of the progressive nature of your condition. Alternatively, it is sometimes hard to visualize every single connection of every vein and predict with 100% accuracy the outcome of treatment, so the new vein may somehow relate to your otherwise successful treatment. Duplex ultrasound should reveal the source.

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Answered by Vein Center of Orange County

If the great saphenous vein is closed and the small ("short") saphenous vein is normal, then the new vein must have a different source and is part of the progressive nature of your condition. Alternatively, it is sometimes hard to visualize every single connection of every vein and predict with 100% accuracy the outcome of treatment, so the new vein may somehow relate to your otherwise successful treatment. Duplex ultrasound should reveal the source.

Published on Jul 11, 2012


Veins etc. at Comprehensive Cardiovascular Consultants

Published on Oct 24, 2013

There may be a perforator vein or pelvic veins causing the varicose veins.

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Answered by Veins etc. at Comprehensive Cardiovascular Consultants

There may be a perforator vein or pelvic veins causing the varicose veins.

Published on Jul 11, 2012


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