Should I get a second opinion?

Endovenous Laser Ablation . 9 answers . 2 years ago

I have spider veins, but no bulging varicose veins whatsoever. Was told that I have 4 incompetent veins and need the laser treatment. Orig went for the spider veins. Is this necessary? Is there another option other than the laser ablation?

ANSWERS FROM DOCTORS


2 years ago by General Vascular Surgery Group

If there are no other symptoms sometimes you can only treat the spider veins but the risk of recurrence may be higher. I always welcome a second opinion if there are questions about a treatment plan.

2 years ago by General Vascular Surgery Group (View Profile)

If there are no other symptoms sometimes you can only treat the spider veins but the risk of recurrence may be higher. I always welcome a second opinion if there are questions about a treatment plan.


2 years ago by Intermountain Vein Center

You can request the sclero injections, but to ensure the success rate, a laser ablation would be best, especially if those veins are large in diameter. Those veins are probably the source of many of your spider veins.

2 years ago by Intermountain Vein Center (View Profile)

You can request the sclero injections, but to ensure the success rate, a laser ablation would be best, especially if those veins are large in diameter. Those veins are probably the source of many of your spider veins.


2 years ago by Bella MD Laser Vein and Aesthetic Center

Definitely get another opinion. Insurance companies will not pay for treatment unless there are symptoms.

2 years ago by Bella MD Laser Vein and Aesthetic Center (View Profile)

Definitely get another opinion. Insurance companies will not pay for treatment unless there are symptoms.


2 years ago by Vein Specialties of St. Louis

The first question I would ask is do you have any symptoms and do they affect your daily life? If you have no symptoms with saphenous insufficiency and a lot of spider veins, your cosmetic treatment of those may not be as effective.
This may just be an incidental finding which many of the population may have. However, if there are symptoms (pain ,aching, heaviness, swelling, cramping etc.) I would treat your Long saphenous veins first and consider the Short saphenous veins at a later date.
You sound as though you are somewhat doubtful in which case I would highly recommend a second opinion with an experienced vascular surgeon who specializes in treating venous disease.

2 years ago by Vein Specialties of St. Louis (View Profile)

The first question I would ask is do you have any symptoms and do they affect your daily life? If you have no symptoms with saphenous insufficiency and a lot of spider veins, your cosmetic treatment of those may not be as effective.
This may just be an incidental finding which many of the population may have. However, if there are symptoms (pain ,aching, heaviness, swelling, cramping etc.) I would treat your Long saphenous veins first and consider the Short saphenous veins at a later date.
You sound as though you are somewhat doubtful in which case I would highly recommend a second opinion with an experienced vascular surgeon who specializes in treating venous disease.


2 years ago by VeinCare Centers of Tennessee

If you do not have pain, tenderness, or swelling at the ankles, you might want to consider a second opinion.

2 years ago by VeinCare Centers of Tennessee (View Profile)

If you do not have pain, tenderness, or swelling at the ankles, you might want to consider a second opinion.


2 years ago by Heart and Vein Center

If your doctor has recommended endovenous laser for the four saphenous veins, means that he most probably saw that you have vein reflux. Although you can still have the treatment of the spider veins, if there is significant venous reflux the results will be better if you have the laser ablation first. On the other hand if you do not have any symptoms on your legs i.e.: swelling, pain, heaviness, restless legs, you could just have the treatment for the spiders and wait 1-2 years to have the laser.

2 years ago by Heart and Vein Center (View Profile)

If your doctor has recommended endovenous laser for the four saphenous veins, means that he most probably saw that you have vein reflux. Although you can still have the treatment of the spider veins, if there is significant venous reflux the results will be better if you have the laser ablation first. On the other hand if you do not have any symptoms on your legs i.e.: swelling, pain, heaviness, restless legs, you could just have the treatment for the spiders and wait 1-2 years to have the laser.


2 years ago by Miller Vein

Most likely you indicated you have symptoms and/or a family history of vein
problems. Then these are indications an ultrasound is usually performed to
determine a medical condition known as venous insufficiency. There are
options available for treatment and laser is one of them.

2 years ago by Miller Vein (View Profile)

Most likely you indicated you have symptoms and/or a family history of vein
problems. Then these are indications an ultrasound is usually performed to
determine a medical condition known as venous insufficiency. There are
options available for treatment and laser is one of them.


2 years ago by Vanish Vein and Laser Center

What you describe is reflux of the valves. You appear to have reflux of the greater and lesser saphenous veins bilaterally. Spider and varicose veins are usually a result of reflux. If you have significant reflux, then you should consider treating this first before undergoing sclerotherapy. Sealing the reflux will give you better sclerotherapy results. Your other option would be to do sclero first and see what happens. The problem here is that, if sclero fails, then you would have wasted your time and money on the sclerotherapy treatments.

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

What you describe is reflux of the valves. You appear to have reflux of the greater and lesser saphenous veins bilaterally. Spider and varicose veins are usually a result of reflux. If you have significant reflux, then you should consider treating this first before undergoing sclerotherapy. Sealing the reflux will give you better sclerotherapy results. Your other option would be to do sclero first and see what happens. The problem here is that, if sclero fails, then you would have wasted your time and money on the sclerotherapy treatments.


2 years ago by Center for Interventional Medicine, LLC

Hello. That is a good question, and you are correct to question the treatment recommendation. If you are not having symptoms such as pain or swelling, then having the underlying incompetent veins treated may be unnecessary. You may be happy with having only the visible spider veins treated. However you should know that if you have venous reflux disease (caused by the incompetent veins), the spider veins may reappear in the future.

2 years ago by Center for Interventional Medicine, LLC (View Profile)

Hello. That is a good question, and you are correct to question the treatment recommendation. If you are not having symptoms such as pain or swelling, then having the underlying incompetent veins treated may be unnecessary. You may be happy with having only the visible spider veins treated. However you should know that if you have venous reflux disease (caused by the incompetent veins), the spider veins may reappear in the future.


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