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Had a phlebectomy and VNUS done 4 weeks ago. I have lumps all along where the vein used to be (ranging from pea size to walnut size). They were painful & had them drained twice now. I still have lumps. What can be done? Will these resolve?
The lumps are remaining vein fragments. They usually resolve with time but
if large and painful they should be evacuated or an attempt made to remove
These lumps are likely thrombophlebitic veins that will resolve with time.
This is a good question...and not so uncommon
Although it is wonderful when no bumps are present after phlebectomy, invariably due to complex anatomy and the imperfect nature of phlebectomy, bumps may be noticed.
The bumps represent a missed/skipped/retained vein section, or a small hemorrhage in the pocket where the vein used to be. If the bumps appear scarred on ultrasound, in time they simply shrink and the skin becomes smooth. If there is flow in the region, you may need additional treatment with chemical ablation (sclerotherapy).
In my practice, when we see the bumps, the course is dependent upon what the ultrasound findings show. If the bump represents an organized scar, we expect the skin to be smooth by the three month mark. I would expect you will be seeing your surgeon in the coming weeks, so that would give you some time to see what happens to the bumps and determine if further treatment may be necessary.
These lumps are very common following both phlebotomy and closure procedures. The hardness along the course of the heated vein is due to scarring and contracture of the vein as well as the blood within the vein becoming clotted from the treatment. The hardness where the microphlebectomies were done is due to clotting or hematoma formation in the disconnected and partially removed veins. Heat applied to these areas will help as well as anti-inflammatory medications. These will resolve over time.