How common are EVLT/microphlebectomy complications? Also, when can I expect to feel well enough to return to work?
I had EVLT/microphlebetomy (16 sites with a stitch or two at each site) 4 wks ago. I could not walk or use my leg normally for 3 wks due to pain in my inner and upper thigh. My doctor diagnosed a thermal burn to the thigh muscle. I also had a second follow-up ultrasound to rule out a DVT after developing red, painful areas on the back of my knee and thigh, and a painful nodule in my groin during week 3-4. Are these complications common? Also, when can I return to work?
Answers from doctors (4)
Sounds like a lot of unusual issues related to the endovenous laser procedure and microphlebectomy.
Most patients get on the treadmill within an hour of leaving my practice or go for a nice work and better than 99% of my patients return to work 12 hours after the procedure, i.e. the next morning.
I don't combine microphlebectomy with endovenous laser, although some do that. I don't advocate that method as of this writing in 2016. The idea is to limit pain and discomfort after the ablation procedure so patients stay active, and this level of activity reduces the likelihood of developing DVT.
"Thermal injury" is also very uncommon if you provide suitable amounts of tumescent anesthesia. If the patient experiences pain or burning during the ablation, the procedure is immediately terminated and more tumescent anesthesia is delivered and then the laser continued to finish the procedure. Doing this in the awake patient effectively reduces the likelihood of thermal injury to nil.
I am sorry that you have had such pain and discomfort after your procedures. Discuss your post op course with your provider.
Published on Jul 11, 2012
Your story is terrible. I never need stitches and my patients can return to light duty the day after operation. You also now have superficial thrombophlebitis. Ibuprofen will help.
Published on Jul 11, 2012
My patients normally experience some soreness in their legs during the first 3-4 weeks following their initial EVLT. The discomfort, however, normally does not significantly limit their activities and tends to dramatically improve during that time. That said, you also had microphlebectomy performed which is a technique that I do not find necessary given that there are alternative treatments that generate less discomfort and are just as if not more effective. The complications that you appear to be experiencing is not really out of the ordinary for what you had done. You have to remember that when you get microphlebectomy, the doc is literally stripping out certain affected veins. This can cause trauma to the leg in the treated areas. It can also leave a lot of untreated vessels remaining in the leg as well. These untreated areas are then left to collect trapped blood and/or pressure spots that can explain the nodules and phlebitis that you are experiencing. I personally prefer ultrasound guided foam sclerotherapy because it does not generate this trauma and helps to minimize the other issues that you are reporting. Follow up treatment is critical to helping to eliminate the issues that you are reporting. Your doc should know how to fix them. If not, you need to find a vein doc who knows what the issue is.
Published on Jul 11, 2012
Any procedure has risks and benefits. Please discuss outcomes with your performing physician.
Published on Jul 11, 2012
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