Should ultrasound be done at regular intervals to ensure that treated veins have remained closed? What is the protocol regarding ultrasound after sclerotherapy and laser ablation?
I don't typically perform an ultrasound after sclerotherapy. I do recommend a 2 day follow-up ultrasound after vein closure to confirm that there are no deep vein blood clots and to assess the effectiveness of the procedure. Three months later, I also obtain a follow-up vein mapping on one or both legs to confirm closure.
Published on Jul 11, 2012
Duplex ultrasound is advised after treating a large vein with either sclerotherapy or laser ablation. Most insurance companies demand that an ultrasound be done to show the patient how well the treatment worked.
Published on Jul 11, 2012
Protocols vary greatly. Having performed ultrasound-guided treatment for over 20 years, I find a single follow up one month later usually suffices to prove closure. If the patient is part of an ongoing clinical study, then annual follow ups are usually performed.
Published on Jul 11, 2012
The protocols vary. The ultrasound can identify unclosed segments, deep vein thrombosis (DVT), feeders or mobile thrombus. If you are concerned, discuss the matter with the treating physician.
Published on Jul 11, 2012
That is a great question and the answer can vary. In our office, we generally follow up at 3 weeks, 3 months and 6 months. From there, it really depends on how the patient is healing, if they have any new symptoms or whether additional treatment is needed.
Published on Jul 11, 2012
Protocols vary from practitioner. My protocol after EVLT is to check post-op, then at 1 week, 6 weeks, 12 weeks and 6 months. I have seen veins begin to recanalize at various intervals, but true failures have been seen from other offices who did not follow their patients, and I have been asked to perform many redo procedures as a result. I believe it is better and easier to catch these before they fail, as an ultrasound guided injection is
easier and quicker than an EVLT redo. Many insurance companies are making it difficult to properly follow these patients as of recent, and require that the patient experience symptoms prior to authorization.
Published on Jul 11, 2012
Usually a one-week follow up is required. With a laser ablation, after a week it is obvious that the vein is closed. After sclerotherapy, sometimes the vein does not close all the way and retreatment is necessary. It is good to have these follow up appointments and to have a follow-up when there is continuing pain and discomfort. Sometimes the physician will do a follow-up in one month and another 6 months later.
Published on Jul 11, 2012
There is no official protocol. There is a 5 percent failure or recanalization rate over 2 years, so that is the rationale for some periodic re-check. If this is caught early, it can be treated with a simple sclerotherapy injection.
Published on Jul 11, 2012
Re-check at three and six months post-procedure.
Published on Jul 11, 2012
The "protocol" varies, but an ultrasound should be done several times time in the first year to be sure the vein is closed and remains closed.
Published on Jul 11, 2012
No ultrasound needed for small sclero treated veins. I usually ultrasound at 1-2 weeks and then 3 months after laser ablation of major veins only.
Published on Jul 11, 2012
We generally do an ultrasound at 2-4 days and then at 1 year.
Published on Jul 11, 2012
Great question. Typically, each clinic will have their own protocols, so there will be variations. We perform an ultrasound examination during and immediately after ablation and sclerotherapy procedures (ultrasound guided sclerotherapy). I examine my patients at two to five days after the ablation and then again at 6 weeks, 3 months, 6 months and 12 months. This will vary according to the individual response. After ultrasound guided sclerotherapy, I typically see them again at 6 weeks and 3 months. If they are not sealed at 6 weeks, I will re-inject at that time.
Published on Jul 11, 2012
Yes, an ultrasound should be done at regular intervals to ensure that treated veins have remained closed. After laser ablation, ultrasounds are usually done at 1-2 weeks, then at 3, 6 and 12 month intervals. Annual checkups then follow.
Published on Jul 11, 2012
Yes, ultrasounds are done at regular intervals to ensure that treated veins have remained closed and to be sure that no new areas of venous insufficiency have developed. My protocol is to check at three months, six months, then yearly after an endovenous laser ablation (EVLA).
Published on Jul 11, 2012
My protocol is to do an ultrasound 7 to 10 days after the closure and then usually 1 year later unless symptoms dictate a more frequent sono.
Published on Jul 11, 2012
There is not a written "protocol". However, it is important to follow up with an ultrasound after each procedure is done, particularly if it is major like endovenous thermal ablation of large truncal veins. The same is true for extensive sclerotherapy or if the patient has symptoms that are concerning, say if due to a complication like deep vein thrombosis (DVT). The rationale is rather obvious to check and make sure that the treatment has been effective and that there are no complications. Also, the ultrasound works as re-evaluation to determine if there is need for more work to be done. There is room to be more lax in cases where the small veins have been injected and there is no clinical evidence of complications.
Published on Jul 11, 2012