I had EVLA and microphlebectomy on my right leg 4 wks ago to treat GSV (from SFJ to ankle) and reflux of SV (from SPJ to ankle). I am in a lot of pain from my shin to the inside of my ankle. It hurts to touch, along with numbness. Will my saphenous nerve repair itself, or is this damage permanent?
Numbness or paresthesia (increased sensitivity) after EVLA is not uncommon and usually improves during the subsequent months or longer
Published on Jul 11, 2012
You are early in the healing process. In my practice I do not treat the entire length of vein especially in the ankle for this very reason. My access to the saphenous is rarely below mid-calf. There are a lot of nerves in the ankle and the vein is very superficial. Additionally I would not treat both veins at the same setting but treat the short saphenous at least a week later. I would recommend you talk with your treating physician how he would like you treat this. I would recommend massage over the numb and painful areas several times per day to desensitize the nerves and some low heat frequently may offer some relief for the discomfort. If your leg feels better with compression hose, wear them during the day. It is not possible to predict the outcome of your complications.
Published on Jul 11, 2012
There have been studies that have shown that 90-95% of that nerve irritation or damage will repair itself within 6 months. Sometimes it may take up to 1 yr, but if the feeling hasn't come back within 1 yr, then it is likely permanent. The pain will subside, but give it a few months. Make sure you have gone in for a follow-up ultrasound to determine if the veins are closed.
Published on Jul 11, 2012
Given that you are 4 weeks out from your EVLT, it is unlikely that your pain is still due to the inflammation caused by the EVLT. More than likely, your GSV and SSV did not completely close and you now have trapped blood in the lumen of the partially closed veins. This trapped blood results in inflammation of those veins, thus the pain. As for the numbness, if your doc lasered you from the ankle to your SFJ and SPJ, they probably damaged your saphenous and sural nerves. If this is the case, the numbness that you are reporting is probably going to be permanent. If they entered you leg higher up closer to the calf, then the numbness may be due to the inflammation in the legs and thus should resolve in several months.
Published on Jul 11, 2012
Tough question to answer without a complete evaluation. Most of the time the damage to the saphenous nerve causes numbness rather than pain and is transient (so it should be resolving or improving with time). I would have a thorough discussion with your provider regarding all possible explanations.
Published on Jul 11, 2012
Nerve damage from saphenous vein treatment often resolves spontaneously, but can take many months. Only time will tell if the damage is permanent or temporary.
Published on Jul 11, 2012
Probably, In the vast majority of cases the saphenous nerve with repair itself after an injury from an EVLA or microphlebectomy . But you have to patience it heals slowly.
Published on Jul 11, 2012
If the injury is secondary to the laser, then usually within one year, and frequently sooner, the nerve will improve. If the nerve was injured from the microphlebectomy, then it may not repair itself. However, over time, the discomfort should resolve and some of the numbness will improve as you heal from the surgery. Fortunately, most of these nerve problems will improve with time, but it may not be perfect.
Published on Jul 11, 2012