I had an endovenous laser ablation on one GSV 90 days ago. Since then, the ankle area has improved but swelling and skin discoloration remain. The follow-up venous test revealed that the lesser saphenous vein is insufficient; it was not before. The MD said it is likely that when the first vein was closed, the lesser vein became overwhelmed and insufficient. He said that it's uncommon and recommends an ablation on the lesser vein. Can this happen and is this a likely explanation?
Whenever a vein is treated, whether with laser or injection, blood is re-distributed in the neighboring veins. This added flow in the collateral branches can cause a vein that is flawed to fail because of the increased volume. So, the explanation regarding the lesser saphenous vein is possible. That said, the reason your symptoms remain is because your doc only treated your GSV. All of the veins you probably see from your thighs down to your ankles are generally all bad. It does not sound like your doc treated any of them. This is why the venous circulation in your legs are still bad and why you still have your symptoms. If you want your swelling and your legs to feel better, you need to address all parts of your vein structure in your legs from top down. Unfortunately, the discoloration is usually permanent.
Published on Jul 11, 2012
That is actually a slightly controversial subject, whether closing insufficient veins can make other veins insufficient. The honest answer from me is that I am not sure that can happen.
Published on Jul 11, 2012
It may happen due to increased venous pressure in an adjacent segment, or because of tributaries and connecting veins.
Published on Jul 11, 2012
It is possible, that by relieving pressure in one vessel you can cause increased pressure in another, and thus result in reflux and need for additional closure/ablation. However, 90 days seems short to see this result. More likely the reflux was there in the short saphenous but was not picked up in the first diagnostic scan. But hard to tell without seeing all studies.
Published on Jul 11, 2012
Any saphenous vein or accessory vein can be insufficient (reflux) over time. Most likely your small saphenous vein was refluxing for a while but may not have been seen on the original sonogram. I would doubt that this vein suddenly began refluxing. I have seen non-refluxing veins become insufficient over time, but it usually is a year or more later.
Published on Jul 11, 2012