I am 30 years old and a vascular surgeon recently diagnosed me with CVI. I don't have any visible varicose veins yet, but I have had lots of pain and swelling in my lower legs for several years. Should I have VNUS or wait until I get varicose veins?
CVI is quantifiable, or measurable. If you do not have any skin changes of CVI (discoloration, redness, dermatoliposclerosis, ulceration, atrophie blanche) and no apparent Varicose Veins, you should know what is the size of the 'insufficient' Saphenous Veins (usually 4mm or smaller considered normal) and degree of venous reflux is present (0.5 seconds or 500 milliseconds or less is considered normal). It is always wise to get a second or third opinion from other specialists who are reputable and highly recommended.
Published on Jul 11, 2012
Pain and swelling in the legs is a significant problem to justify the procedure. No need to wait for the appearance of varicose veins. They may never appear. Varicose veins are another symptom of CVI. Many more exist. We do not have to wait for all.
Published on Jul 11, 2012
Please get a second opinion. It will help you decide
Published on Jul 11, 2012
Not everyone with CVI has superficial varicose veins, but they can have a lot of symptoms. You are definitely a candidate for ablation—either radiofrequency or laser. I prefer laser in my practice. In some instances, insurance plans will not cover treatment if there are no varicose veins present. I would have your surgeon appeal this decision if it occurs.
Published on Jul 11, 2012
Venous insufficiency can occur with or without tributary varicosities. Untreated venous insufficiency will eventually cause the formation of varicose veins. If you have symptoms, I recommend that you proceed with the procedure if compression stockings fail to relieve your symptoms.
Published on Jul 11, 2012
Great question. Your provider may have explained that varicose veins are not always readily visible with the naked eye. In other words, varicose veins may be appreciated through an ultrasound study. Regardless, this
usually presents as a later manifestation of the disease and should not be a major factor of your decision to pursue treatment. I would focus more on treating your pain and swelling, rather than what your legs look like.
Published on Jul 11, 2012
The swelling is probably not due to GSV incompetence, and VNUS is unlikely to change it. Truncal ablation may occasionally be indicated in the absence of varices, depending on individual circumstances.
Published on Jul 11, 2012
You don't specify the source of your CVI, but if your doctor has diagnosed CVI by duplex ultrasound and thinks the VNUS procedure will yield symptomatic improvement which you would welcome, then proceed with thermal ablation. I see very few patients who have symptoms of CVI due to superficial veins without surface varicosities as you describe, but when it does occur, treatment is usually successful. If there is any doubt, you can always get a second opinion before proceeding.
Published on Jul 11, 2012
If you have reflux and symptoms related to the reflux, then you would benefit from a closure procedure (Venefit or any other closure procedure). You do not have to have varicose veins to be eligible for valve closure. CVI is an indication for closure.
Published on Jul 11, 2012
I haven't seen or examined you, but from what you are describing, you may be an excellent candidate for the Venefit procedure. It may help your pain and swelling significantly.
Published on Jul 11, 2012