My 84-year-old mother has been scheduled to have a vein closed in her left leg, from the knee up. Is this necessary? What happens if she doesn't do it? What side effects to expect? When after that could she safely travel to Europe? She is fragile. I worry for her.
Make sure you find a physician who is accredited by the American College of Phlebology. Other than potential numbness from the procedures, the side effects are minimal. The procedures are safe and very effective. Now if she has medicare, then she will most likely have to wear knee high 20-30 compression stockings for 3 months before treatment, but if there is no pain or skin deterioration (which can lead to ulceration), then at this point it might not be worth the trouble or money. If there is skin discoloration/ulceration/pain associated with the varicose veins, then it is always worth it.
Published on Jul 11, 2012
This procedure should be done in symptomatic patients ONLY, with leg heaviness, pain, throbbing and/or skin changes, such as pigmentation, bleeding and ulcers. She should wait at least a week to travel. She could just opt for just wearing knee high compression stockings.
Published on Jul 11, 2012
ELA is a safe operation and indicated wen the patient has significant leg pain or swelling when she is on her feet even in 90 year olds. She can travel if she moves around and flexes her ankles while being on the jet.
Published on Jul 11, 2012
This sounds like a great saphenous vein ablation from the knee to the saphenofemoral junction. Whether ablation is necessary depends on her symptoms, ultrasound findings as well as her medical history. It is very important for your mother to discuss with the treating physician the risks, benefits and alternatives to the proposed procedure which are specific to her medical condition. There is not an age limit on vein procedures. If your mother would allow, you may want to schedule a visit with the treating physician when another adult relative can be present to hear and understand the information that is being presented to her.
Most people tolerate ablation well. We recommend compression stockings for 2 weeks post procedure. Bruising is common, and some people experience a tugging sensation along their thigh. Other rare but possible side effects include deep venous thrombosis (blood clot), skin pigment changes, nerve injury or infection. Again, these risks should be discussed with the treating physician. We do not recommend extended air travel for at least a month post ablation.
Published on Jul 11, 2012
If your mother has symptomatic varicose veins, then a vein closure will certainly help her. As a vascular-trained surgeon, I also remove some of the bulging veins in the same setting.
It is important for her to be wearing compression hose (thigh-length) before and after this procedure and definitely before she flies to Europe. I will typically allow my patients to make a long flight a week later after I see them.
She must drink plenty of fluids, get up and walk as often as possible, do the exercises that all flight magazines have in the back section. If her PCP allows, I recommend a daily Aspirin 81 mg.
The procedure is minimally invasive, done in the office under local anesthetic and she will be able to walk immediately with a light dressing and compression hose. This all reduces possible complications that can occur in a hospital surgery center and anesthesia.
Published on Jul 11, 2012
The ELA procedure is very safe. Many precautions can be taken to help her avoid issues when she travels. The risks and benefits of the procedures should be discussed thoroughly with your provider. Is she in significant pain? Do the few small risks outweigh the probability that she will feel much better? Worse thing that happens if she doesn't have it done, is she simply continues to deal with her symptoms.
Published on Jul 11, 2012
If she has a good medical indication and venous reflux, then I would say, yes she needs the procedure. The procedure is very safe even for an elderly and frail lady. After few days of recovery, there should be no contraindication to travel to Europe.
Published on Jul 11, 2012
Certainly reasonable to question when your Mother is of such age. The main question here is how active is she? If an active 84 year old like my Mom, and the level of disease she has prevents her from doing things she wants to do - or if she has advanced disease with ulcers - than it is very much worth doing. This assumes she does not have any other serious health problems that would suggest she leave it alone.
Assuming she is in the hands of a good vascular surgeon who does a lot of these procedures - and that it is being done in the simplest and safest setting (my opinion is a well operated office setting), she should be fine. The complications are very low and those that exist are for the most part pretty benign. But if she has persistent pain, itching, swelling, bad veins etc., than this procedure can be very gratifying. We prefer using RF technology (low heat) for our elderly patients - laser (high heat) can be a bit harsher. We normally clear our patients for flying at their 48-72 hour post op ultrasound, that assures there are no unexpected clots that would need treatment.
Published on Jul 11, 2012
You need to speak with your treating physician and find out the reason for the vein closure procedure. Age is not a contraindication to the procedure. More importantly, what is the indication for the procedure? Your doctor will answer this for you and then you can decide whether or not to proceed. As far as flying, I recommend not flying for 2 weeks following closure procedures.
Published on Jul 11, 2012
Unless she has symptoms or severe varicose vein I would generally not do this in an 86 year old.
Published on Jul 11, 2012
Her doctor is the best person to assess. Complete history and physical examination. Depends on severity of the vein and her symptoms.
Published on Jul 11, 2012