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If I have had large vessels such as the saphenous closed, is there chance of circulatory problems later on?
Endovenous laser ablation is minimally invasive and very safe. The
worst complication would be a blood clot in the leg. This is very rare
complication compared to any surgical procedure. In answer to your
second question, if the larger saphenous vein is refluxing, or non
functioning, the blood has already by- passed that vein. So when you
close it off, it will actually make your leg health improve and help
preserve the normal veins. The long term venous health will improve if
the vein is ablated, but if untreated, will only become worse.
Not likely since your closing an already disfunctional vein.
No. The majority of blood is carried out of your legs by the deep venous system. The superficial system carries only a minority of blood. The saphenous veins are part of the superficial system. Also, if you have a leaking saphenous vein, closing it down (with laser) will actually improve your venous circulation.
Most of the times there is no reason to be afraid.
Endovenous ablation is a remarkably safe & effective procedure for the treatment of superficial venous insufficiency. All invasive procedures carry with them some associated risks. The risks of endovenous laser procedures can be broken down into those associated with the device: either laser or radiofrequency ablation , those associated with steps in the procedure i.e. vein access, application of anesthetic, and the long-term sequelae of the procedure.
1. Device related complications: Both Laser and Radiofrequency ablation work through the generation of heat. This heat can be transmitted through the vein wall and injure associated nerves and skin. A short-term sensory neeropathy can occur in 5-10% of cases. Thermal injury to the skin is much less common, but skin burns have been reported most frequently in the early use on the RF devices. A DVT (Blood Clot) can form related to trauma to the common femoral vein. This is why we get a venous ultrasound a few days after the procedure. This occurs < 3% of the time and will often require a short term treatment with systemic anticoagulation with coumadin.
2. Complications related to steps in the procedure: Allergic or toxic reactions to Lidocaine/epinephrine are very rare when used in appropriate doses, but can include seizures and heart arrythmias.
Difficulty accessing the vein can occur and rarely a small incision is required, this rarely occurs, but is more frequent in less experienced users. Sometimes the vein will be too tortuos or have segmental occlusions that will not allow the wire/catheters to pass and will require more than one vein puncture. This can usually be identified with good pre-procedural vein mapping.
3. Complications related to the long-term sequelae of ablation: The insufficient vein is functioning to "short-circuit" the normal function of the venous system. by the time these veins are treated they are usually thin-walled and dilated and would not be useful conduit for coronary or periphe
If you have an enlarged, incompetent saphenous vein, removing it will improve the return venous circulation. If you do not treat this vessel, it will become larger, more incompetent and further impair return venous flow. We routinely see advanced stages of venous disease where people present with skin ulcerations around the ankles, and we watch these resolve and heal after we remove the incompetent saphenous veins.
This is a commonly asked question. If the saphenous vein is incompetent,closing it with a laser should actually improve your circulation by allowing the venous blood to return to your heart through the deep system of veins rather than to pool in the leg veins and form varicose veins. There is a compromise, however, because the saphenous vein could no longer be used for a coronary bypass in the future. There are other options for bypass including the radial arteries, internal mammary arteries and arm veins.
As with any procedure, there can be complications, so it is important to have the procedure performed by a qualified physician.
The most serious complication is a clot in the deep system of veins. Another potential issue are the inadequate closure of the treated vein, leading to recurrent varicose veins. Overall the procedure is safe and successful in the majority of patients.