I had EVLT performed on both legs. A week later, I had a foam sclerotherapy treatment. I developed thrombophlebitis following the procedures, and was given ibuprofen 600 for 2 weeks. I am finding that I still have no relief. There is pain behind my knee & inner thigh. What should I do?
You should return for evaluation by your vein doctor. Phlebitis can be related to the foam sclerotherapy, and they may be able to remove some of the “trapped blood” to relieve some of your discomfort.
Published on Jul 11, 2012
This is unusual to have this pain for this length of time. Your surgeon should check for areas of trapped blood in more superficial veins and drain them if present. My patients are on ibuprofen only for 7 days post-EVLT. I, as a vascular-trained surgeon, perform microphlebectomy on the larger varicose veins at the same setting and avoid injecting them for this very reason.
I would recommend trying low heat over the areas as often as you can, wear your hose, and continue the ibuprofen (take with food).
Published on Jul 11, 2012
Often the doctor or nurse practitioner will recommend a daily dose of aspirin which will help with the healing of the small clot. Is it in the the superficial system for the deep system? If it's in the superficial system and in veins that need to be treated, the clot treats those veins, causing inflammation and scar tissue that your body will reabsorb. When there are clots in veins it usually takes a few month process to resolve completely. Make sure you follow up with your primary care physician and verify that your vein doctor is accredited by the American College of Phlebology.
Published on Jul 11, 2012
Since you are not on blood thinners, I must assume you have superficial and not deep vein thrombosis. See your doctor to make sure it has not progressed before seeking more conservative treatment. A strong clue to
support more dangerous deep vein thrombosis would be obvious ankle swelling on the affected leg, which demands immediate medical attention.
Published on Jul 11, 2012
I will have to refer you back to you clinician. We do not use EVLT in our practice.
Published on Jul 11, 2012
The clinic performing the procedures should re-evaluate the veins in your legs with ultrasound. They need to determine the extent of the thrombophlebitis. Symptoms from phlebitis may persist for 3 to 6 weeks. Wearing compression stockings may help.
Published on Jul 11, 2012
Thrombophlebitis is a very real risk with the foam sclerotherapy procedure; that is why we opt for the microstab phlebectomy procedure in treating varicosities. I am sorry you are having so much discomfort, thrombophlebitis can be quite uncomfortable. Your best course of action at this point is to continue to wear compression, which I assume you are doing. Also, elevate your leg when possible and use NSAID medication (like ibuprofen). The NSAID should be taken on a regular schedule and with food in order to avoid any GI disturbance. Lastly, use very low heat on the affected areas and give your condition time. Thrombophlebitis does not resolve overnight.
Published on Jul 11, 2012
You probably have trapped blood from the foam sclerotherapy. The result is localized inflammation in the treated vessels; thus your phlebitis. The solution is simple: Have the trapped blood removed. This should resolve your discomfort within a few days. The doc who treated you should know this if they specialize in vein treatment. If not, find someone who is competent to be in charge of your care.
Published on Jul 11, 2012
You should be wearing compression stockings every day. Once a DVT has been ruled out, your (superficial) thrombophlibitis will resolve over time with compression, NSAIDs, and leg elevation when not ambulatory.
Published on Jul 11, 2012
Follow up with your doctor. Do you have deep or superficial thrombophlebitis? If it is superficial, your doctor should poke the trapped blood to drain it. This will provide relief. If you have deep thrombophlebitis, you need more work up and different medication.
Published on Jul 11, 2012
Thrombophlebitis of the treated veins is actually what the treatment does (both EVLT and foam sclerotherapy). This means that the treatment is actually working. If your deep veins are normal, just take ibuprofen and wear compression stockings.
Published on Jul 11, 2012
Assuming you have superficial thrombophlebitis and not deep venous thrombosis, I would recommend 4 things:
1. Continue ibuprofen
2. Continue compression with stockings
3. Exercise. The more you move, the better.
4. Pick up some Arnica gel and spread it over the effected area.
Published on Jul 11, 2012
You should have a repeat venous ultrasound to ensure that you do not have a DVT which is causing your pain. If this is the case, then anticoagulation is indicated. If you have superficial phlebitis, then the treatment is ibuprofen, warm compresses, and support stockings. All three of these measures will help. It could also be that the cause of your discomfort is not the phlebitis but the lasered vein, which may take up to 6 weeks to heal.
Published on Jul 11, 2012