Why has EVLT not improved my chronic leg swelling?

Endovenous Laser Ablation . 7 answers . 2 years ago

It's been 4 wks since I had EVLT and Phlebectomy of my left leg. I continue to have the same chronic, daily leg swelling that I did before treatment. I have a follow-up appt in 3 mths but I am less than optimistic. What should I expect next?

ANSWERS FROM DOCTORS


2 years ago by General Vascular Surgery Group

Tough question there are many causes for swelling not just veins. See your provider

2 years ago by General Vascular Surgery Group (View Profile)

Tough question there are many causes for swelling not just veins. See your provider


2 years ago by Intermountain Vein Center

That would signify that the problem is not vein related. It could be arterial but that would be something for your physician to determine through some tests.

2 years ago by Intermountain Vein Center (View Profile)

That would signify that the problem is not vein related. It could be arterial but that would be something for your physician to determine through some tests.


2 years ago by Vein Specialties of St. Louis

I always explain to my patients pre-operatively, that it cannot be guaranteed that the leg swelling is due to the saphenous incompetence. However, if a trial of conservative therapy (leg elevation, exercise, compression hose of at least 20-30 or 30-40mmHg pressure correctly fitted) reduces the edema, ablation very often alleviates the problems. If the swelling is only in the left it could be of lymphatic nature but if in both, it could be cardiac. You should follow-up with your vascular surgeon before 3 months. I would also highly recommend you continue compression hose. Apply them in the morning before you get out of bed.

2 years ago by Vein Specialties of St. Louis (View Profile)

I always explain to my patients pre-operatively, that it cannot be guaranteed that the leg swelling is due to the saphenous incompetence. However, if a trial of conservative therapy (leg elevation, exercise, compression hose of at least 20-30 or 30-40mmHg pressure correctly fitted) reduces the edema, ablation very often alleviates the problems. If the swelling is only in the left it could be of lymphatic nature but if in both, it could be cardiac. You should follow-up with your vascular surgeon before 3 months. I would also highly recommend you continue compression hose. Apply them in the morning before you get out of bed.


2 years ago by The Sheen Vein Institute

Chronic swelling in the legs from vein disease can take months to resolve despite EVLT and phlebectomy. However, EVLT and phlebectomy alone often only allows you to treat some of the abnormal veins in your vein network. In my experience, in order to properly treat a patient's leg swelling, you need to treat all aspects of your vein structure that is abnormal. This includes any spider veins or reticular veins above and below the knee. Performing EVLT and phlebectomy alone will not allow you treat all of these vessels. This may be why your swelling has not resolved.

2 years ago by The Sheen Vein Institute (View Profile)

Chronic swelling in the legs from vein disease can take months to resolve despite EVLT and phlebectomy. However, EVLT and phlebectomy alone often only allows you to treat some of the abnormal veins in your vein network. In my experience, in order to properly treat a patient's leg swelling, you need to treat all aspects of your vein structure that is abnormal. This includes any spider veins or reticular veins above and below the knee. Performing EVLT and phlebectomy alone will not allow you treat all of these vessels. This may be why your swelling has not resolved.


2 years ago by Angelo N. Makris MD

In my experience, there are usually multiple factors that cause leg swelling. Therefore, treating the patient's superficial venous insufficiency usually improves swelling (if it was a contributing factor to the swelling), but does not usually resolve all the swelling.

2 years ago by Angelo N. Makris MD (View Profile)

In my experience, there are usually multiple factors that cause leg swelling. Therefore, treating the patient's superficial venous insufficiency usually improves swelling (if it was a contributing factor to the swelling), but does not usually resolve all the swelling.


2 years ago by Heart and Vein Center

There are many reasons why you still have swelling: you might still have insufficiency of the small saphenous veins, you might have insufficient perforators, you might not be walking enough or not wearing the right compression stockings.

There are some other reasons that are not "vein related", but will be too much to elaborate...
You need a re-evaluation sooner than 3 months.

2 years ago by Heart and Vein Center (View Profile)

There are many reasons why you still have swelling: you might still have insufficiency of the small saphenous veins, you might have insufficient perforators, you might not be walking enough or not wearing the right compression stockings.

There are some other reasons that are not "vein related", but will be too much to elaborate...
You need a re-evaluation sooner than 3 months.


2 years ago by Vanish Vein and Laser Center

It could be that your leg swelling was NOT due to reflux of the saphenous system and varicose veins. There are a multitude of causes of leg swelling such as deep venous reflux, lymphedema or medications. You probably need further work up for the cause of the leg swelling.

2 years ago by Vanish Vein and Laser Center (View Profile)

It could be that your leg swelling was NOT due to reflux of the saphenous system and varicose veins. There are a multitude of causes of leg swelling such as deep venous reflux, lymphedema or medications. You probably need further work up for the cause of the leg swelling.


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