My leg feels heavy and aches continuously

Foam Sclerotherapy . 2 answers . 3 years ago

I had endovenous laser ablation for my great saphenous vein and foam sclerotherapy on the same day 6 months ago. I got phlebitis and now my leg aches

My leg has new veins where I had phlebitis and my leg feels very heavy and aches continuously day and night. What could be causing this and how long before I could consider a re-treatment for reflux? Should I continue to wear the compression stocking?

ANSWERS


3 years ago by Vein Specialty Medical Clinic, Inc. (View Profile)

A detailed ultrasound evaluation must be done on your remaining and treated varicose veins. Your symptoms are typical for superficial phlebitis of sclerosed varicose veins. This kind of phlebitis is very stubborn and the best management of it is remove the trapped blood ( which is releasing inflammation mediators in that area) in multiple sessions, until you feel you pain and discomfort is gone. Removal of trapped blood requires an experienced phlebologist in doing so. After locating the trapped blood (clot) in the sclerosed large varicose veins, I use 2% lidocaine, and then under ultrasound guidance, I aspirate the clot using G16 and G14 needle connected to a 5ML syringe. I also advise the patient to take Aleve 2 tablets twice daily (with food) for 1 week, and then cut to one tablet twice daily, provided there is no history gastro-intestinal ulcer or bleeding. Removal of trapped blood should be repeated once a week for 2-4 times until patient feel a lot more comfortable. With each attempt only part of trapped blood can be aspirated, unless the clot consistency has changed to a soft and non sticky stage (gone through lysis), at which time even with one attempt at aspiration, all of the clot can be removed. AFter the removal , the discomfort goes away in a matter of 2-3 hours. If this inflammation producing trapped blood is not removed, the pain and discomfort and skin pigmentation of same area can persist for many months.
Khalil Fattahi, MD
Certified, AMerican Board of Phlebology

3 years ago by Vein Specialty Medical Clinic, Inc. (View Profile)

A detailed ultrasound evaluation must be done on your remaining and treated varicose veins. Your symptoms are typical for superficial phlebitis of sclerosed varicose veins. This kind of phlebitis is very stubborn and the best management of it is remove the trapped blood ( which is releasing inflammation mediators in that area) in multiple sessions, until you feel you pain and discomfort is gone. Removal of trapped blood requires an experienced phlebologist in doing so. After locating the trapped blood (clot) in the sclerosed large varicose veins, I use 2% lidocaine, and then under ultrasound guidance, I aspirate the clot using G16 and G14 needle connected to a 5ML syringe. I also advise the patient to take Aleve 2 tablets twice daily (with food) for 1 week, and then cut to one tablet twice daily, provided there is no history gastro-intestinal ulcer or bleeding. Removal of trapped blood should be repeated once a week for 2-4 times until patient feel a lot more comfortable. With each attempt only part of trapped blood can be aspirated, unless the clot consistency has changed to a soft and non sticky stage (gone through lysis), at which time even with one attempt at aspiration, all of the clot can be removed. AFter the removal , the discomfort goes away in a matter of 2-3 hours. If this inflammation producing trapped blood is not removed, the pain and discomfort and skin pigmentation of same area can persist for many months.
Khalil Fattahi, MD
Certified, AMerican Board of Phlebology


3 years ago by Vanish Vein and Laser Center (View Profile)

6 months is a long time after EVLT and sclerotherapy to continue having leg discomfort. You should be reevaluated with a venous ultrasound to look for reflux as well as superficial or deep phlebitis. I would continue to wear compression stockings, but, more importantly, get reevaluated by your vein specialist.

3 years ago by Vanish Vein and Laser Center (View Profile)

6 months is a long time after EVLT and sclerotherapy to continue having leg discomfort. You should be reevaluated with a venous ultrasound to look for reflux as well as superficial or deep phlebitis. I would continue to wear compression stockings, but, more importantly, get reevaluated by your vein specialist.


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