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After the GSV is lasered shut above the knee, the section from the knee to the foot is sore and feels cord or tube-like. How does this pain resolve? Is the lower half of the vein absorbed as well?
Very good question. After the procedure, your vein doctor needs to do an ultrasound of the greater saphenous vein, as well as the lower greater saphenous vein because sometimes they get closed off or might result in phlebitis (inflammation of the veins).
When it is not possible to use thermal ablation to the lower portion, many physicians combine thermal ablation of the thigh portion of the great saphenous vein with sclerotherapy of the calf portion to seal off the
entire vein. This is not always necessary. Your treating physician can give you details about your specific case.
There are plenty of perforating veins to drain the GSV below knee. If you have inflammation, there might be some superficial thrombophlebitis. An ultrasound can clarify what is going on. Meanwhile, wear compression hose.
That cord-like feeling is a good sign; it let's you know that the vein is shutting down as the procedure intends. Over time, possibly a few months, the pain and cord-like sensation will resolve.
It may have clotted off, which is not unusual and NOT dangerous. It will gradually improve.
May close or stay open with/without further progression of varicose veins.
Typically, if you laser the upper portion of the GSV, the lower portion remains there and functions as usual. What it sounds like in your given situation is that your GSV below the knee was actually impacted by the laser or possibly any potential sclerotherapy treatments that you may have received. The fact that it is sore and feels like a cord tells me that you either have trapped blood in this lower portion of the GSV or you have a thrombophlebitis in that section. Which is the cause is difficult to ascertain without ultrasound to actually see what is going on. When or if the pain will resolve is dependent on the cause. The lower half of the vein will not resolve unless the vein completely shuts down and scars in. That is again difficult to accurately answer unless you ultrasound the leg.
Usually, greater saphenous laser closure ends at around the knee joint or slightly below. The saphenous vein below this usually remains open. It can, however, clot if it has been treated by sclerotherapy, which I routinely do during ablation. From what you describe, the vein appears to be clotted and should reabsorb over time. A venous ultrasound would prove this. Symptomatic treatment with NSAIDS, heat and compression should improve the symptoms.
What likely happened is the section below the knee spontaneously closed after it lost blood flow from above. You now have an inflammation of the vein (phlebitis), which should resolve over time as the body scars it down and absorbs it.