I had endovenous laser ablation treatment December of 2013. The vein is still very hard from top to bottom, and my treated leg is very darkly bruised over almost the entire length of the original vein. It looks terrible. The doctor says he has never seen this before and is not sure how to treat it. Do you have any suggestions?
I'd suggest getting a seocnd opinion from a physician who is a phlebologist (varicose vein specialist).
Published on Jul 11, 2012
You should seek a second opinion from a physician who is experienced in treating venous disease.
Published on Jul 11, 2012
The simple answer to your question is that the vein that your doc lasered, probably did not close entirely resulting in trapped blood collecting in the lumen of the vein. This trapped blood can cause you to have an external bruise like discoloration along the length of the treated vein that will not go away until that trapped blood is removed. The vein can remain hard due to the trapped blood. Once removed the vein should feel smaller and will eventually go away.
Published on Jul 11, 2012
The vein was probably close to the skin surface when it was treated. The vein itself should be reabsorbed as scar tissue after a few months. It is not uncommon to see reactions like yours and sometimes when the vein is close to the skin surface, you can see it through the skin. If the doctor is confused, I would find another physician. Make sure it's a physician who is accredited by the American College of Phlebology. To this point, it might need to be injected with sclero to finish the treatment, or an I&D as well could be done. A laser ablation is not going to fix the entire problem either, no matter what a physician tells you; the ablations just cut off the source, but do not fix all the other problems.
Published on Jul 11, 2012
The hardness and brown color is from the vein that was closed, which is close to the skin. The vein will slowly disappear. The brown color may take several more months to clear.
Published on Jul 11, 2012
It is very difficult to try to assess what the problem is after all this time. It is certainly something out of the normal. It is possible that you have tissue thickening in response to the heat from the laser. If the vein was very superficial (close to the surface) there can be darkening, pigmentation (hemosiderin) from the vein as it heals. It may not be possible to resolve your problem. I would try massaging firmly over the areas using a cream such as Dermaka, maybe add some extra licorice root exctract. You should move the surface skin over the deeper tissues. Several times per day is beneficial. Again, after this amount of time it may not resolve.
Published on Jul 11, 2012
Most likely the vein that was "ablated" is very close to the skin. This should resolve as your body "eats" the vein up.
Published on Jul 11, 2012
It sounds like a follow-up ultrasound is necessary. There may be residual vein issues.
Published on Jul 11, 2012
This can occur following endovenous ablation, usually when the treated vein is close to the skin surface. The vein has clotted from the ablation and because it is close to the skin, it can be felt and is hard. The discoloration is also from the clotted blood within the vein. The treatment would initially be to apply wet warm compresses but, if still present after 3 months (you are now 7 months), I would place you under local anesthesia and make small holes in the clotted vein about every 4 to 6 inches to drain the clot. This can be done with a 20 gauge needle with excellent cosmetic results.
Published on Jul 11, 2012