I have been getting treatment for my varicose veins and had endovenous laser ablation done. About a month later, the office staff required me to have (I think saline) injected into my veins with an ultrasound guided tech helping. Why is this necessary? My small varicose veins are still visible by the way. Is this a normal practice?
It is not uncommon to require several procedures to eliminate varicose veins. Once the large vein is taken care of, it is often necessary to perform sclerotherapy to eliminate the smaller veins.
Published on Jul 11, 2012
It is not unusual to have ultrasound guided sclerotherapy after a thermal ablation. There are a number of reasons why this may have been necessary. You may have had a part of the vein that was tortuous or too "curvy" to get the ablation catheter through, or perhaps an area where the vein was too small. They may have been treating a large branch or varicose vein and waited a month after the ablation to see if these would shut down on their own. If you still have visible varicose veins that you would like to have eliminated, discuss options with your physician such as phlebectomy or sclerotherapy.
Published on Jul 11, 2012
Endovenous laser treats the saphenous vein trunk and in some patients this alone may result in decrease in size of the varicose veins or eliminate them. If they are still present after endovenous ablation, the varicose veins can be treated with injections or removal. If you have no symptoms after treatment then you can leave the varicose veins as is.
Published on Jul 11, 2012
After laser or RF closure of long veins (ie. Great saphenous or small saphenous) most branches off those long veins close with the heat of the closure. However sometimes larger branches or tributaries do not close on their own. These branches usually feed clusters of spider veins or varicose veins on the surface of the skin. Leaving these open can cause re-opening of the long veins and can still cause pain (thus not cosmetic). Also, visual sclerotherapy of spider veins will likely fail if these feeders are not treated first. We also sometimes use ultrasound guided sclerotherapy for treating refluxing perforator veins that are found on the initial ultrasound and not able to be treated with laser or RF (also medically necessary). Not sure your exact situation, but it is a normal practice. As for the small varicose veins still visable, they will be tender and hard for a good 3-6 months after sclerotherapy.
Published on Jul 11, 2012
Endovenous closure treats the refluxing valves of the saphenous system of veins, which is the cause of the varicose veins, but the procedure does not treat the varicose veins. Following a closure procedure the varicose veins may shrink a little but will not go away. Either microphlebectomies or ultrasonic guided sclerotherapy is then used to treat the varicose veins.
Published on Jul 11, 2012