I had EVLA 8 months ago. My legs are still sore from knee to ankle when light pressure is applied. I had a 7-month ultrasound which shows the veins failed to close from my knee to ankle. I'm 30 yrs old, is this unusual or of concern? What now?
The answer to your question is a little more complex than just yes/no. First off, if the doc who did your initial EVLA was not proficient in that procedure, they may have not put enough energy into the laser to effectively close your vein. That is one possible reason. Secondly, a lot of docs only do a laser on a person's leg and nothing else. The problem with this method of treatment is that if you have any refluxing side branches feeding off of your saphenous vessels, those refluxing branches can over time actually re-open the treated vein. This is why proper vein treatments require persistent follow ups with ultrasound and an initial treatment that addresses all aspects of a person's vein disease (large, medium and small veins).
Published on Jul 11, 2012
From the sounds of it, you need additional treatment.
Published on Jul 11, 2012
There is probably another vein that is feeding the open area. Usually, the most distal portion of the vein that is ablated will clot, scar, and close off unless there is a vein feeding it from below. You probably have more veins to treat. If your current treating physician is not board-certified, I'd suggest you find one that is accredited by the American College of Phlebology.
Published on Jul 11, 2012
This is very common. Often, this area is not treated at all. See a vein specialist for a consultation.
Published on Jul 11, 2012
This complicated question needs to be addressed by your MD.
Published on Jul 11, 2012
I would say that is usual and normal, assuming the ablation was from your knee to the groin. The vessels below the ablation site will usually stay open so long as there is an entrance and exit for the flow. I bring my patients back one month after their ablation for ultrasound-guided chemical ablation of the remaining open and abnormal vessels.
Published on Jul 11, 2012
Those lower leg tributaries need to be closed or removed separately. Your MD cherry-picked if he did not tell you those would also need to be done. If he doesn't provide that service then he was not qualified in my opinion to treat your entire problem.
Published on Jul 11, 2012
Maybe the ablation was not performed below the knee.
Published on Jul 11, 2012
While this is unusual, it can occur. The ablation doesn't normally start as low as the ankle due increased possible complications. In most patients, the valves in the lower leg are functional after the ablation. I would recommend treating this area with ultrasound-guided sclerotherapy.
Published on Jul 11, 2012
While experienced doctors achieve closure rates over 95%, rarely some veins can be resistant to thermal ablation. The ultrasound should show whether thermal ablation can be repeated or, if not, that ultrasound-guided sclerotherapy can finish the job.
Published on Jul 11, 2012
EVLT usually is done from the groin down to about the knee or just below it. The saphenous vein is not treated in most instances from the mid-calf down because the nerves in that area are close to the vein and can be injured by the laser. The saphenous vein from the knee to the ankle is not usually treated unless it is causing varicose veins.
Published on Jul 11, 2012
No, after endovenous laser ablation it's normal for the veins to remain open from knee to ankle. If you are still having symptoms, you may need additional treatment or continued compression by way of stockings.
Published on Jul 11, 2012