I had an EVLT procedure a year ago on my right leg. Now I have more varicoses veins, and my ankle and foot are swelling and painful. Is this normal?

The doctor wanted to do my left leg also and I am happy I didn't do it. What is the next step? Should I get a second opinion?

Answers from doctors (24)


More About Doctor Laser Vein Center

Published on Apr 13, 2015

I would recommend you get an evaluation by another doctor or by your current doctor to see what is going on.

Answered by Laser Vein Center (View Profile)

I would recommend you get an evaluation by another doctor or by your current doctor to see what is going on.

Published on Jul 11, 2012


Advanced Vein Center

Published on Apr 08, 2015

Yes, you should get a second opinion including another duplex ultrasound. I think the right leg issues need to be resolved before moving on to the left leg.

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Answered by Advanced Vein Center

Yes, you should get a second opinion including another duplex ultrasound. I think the right leg issues need to be resolved before moving on to the left leg.

Published on Jul 11, 2012


Recurrence of varicose veins can occur after a prior EVLT and frequently is the result of a new pattern of veins arising from a different vein than the one closed with EVLT. If you are having symptoms, you should see a physician and have an ultrasound performed to determine the most appropriate next step.

Answered by Weill Cornell Vein Treatment Center (View Profile)

Recurrence of varicose veins can occur after a prior EVLT and frequently is the result of a new pattern of veins arising from a different vein than the one closed with EVLT. If you are having symptoms, you should see a physician and have an ultrasound performed to determine the most appropriate next step.

Published on Jul 11, 2012


Goodman Vein & Laser Center, LLC

Published on Apr 04, 2015

It is not uncommon to develop new varicosities after any vein procedure. The ankle and foot pain and swelling is more problematic. You certainly should see a vein specialist, preferably a vascular surgeon, who specializes in vein procedures.

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Answered by Goodman Vein & Laser Center, LLC

It is not uncommon to develop new varicosities after any vein procedure. The ankle and foot pain and swelling is more problematic. You certainly should see a vein specialist, preferably a vascular surgeon, who specializes in vein procedures.

Published on Jul 11, 2012


What you are describing could be due to several reasons (in order of likelihood): 1) not the entire vein was treated; 2) the entire vein was treated, but some segment of this vein became opened again; 3) some branches of the treated vein became independent, often called "accessory" veins. Either of the above can be corrected, but you need to be evaluated first. Hope it helps! Good luck!

Answered by New York Vein Treatment Center (View Profile)

What you are describing could be due to several reasons (in order of likelihood): 1) not the entire vein was treated; 2) the entire vein was treated, but some segment of this vein became opened again; 3) some branches of the treated vein became independent, often called "accessory" veins. Either of the above can be corrected, but you need to be evaluated first. Hope it helps! Good luck!

Published on Jul 11, 2012


Byrne Road Vein Clinic

Published on Apr 03, 2015

Did you have a venous scan done after your EVLT to see if it was successful? You may have another vein in your leg that is causing the problem – you need to have another reflux study done.

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Answered by Byrne Road Vein Clinic

Did you have a venous scan done after your EVLT to see if it was successful? You may have another vein in your leg that is causing the problem – you need to have another reflux study done.

Published on Jul 11, 2012


Elmore Medical Vein & Laser Treatment Center

Published on Apr 02, 2015

You need a second opinion, this is a poor result. EVLT is only part of a complete treatment for varicose veins.

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Answered by Elmore Medical Vein & Laser Treatment Center

You need a second opinion, this is a poor result. EVLT is only part of a complete treatment for varicose veins.

Published on Jul 11, 2012


Texas Vein And Cosmetic Specialists

Published on Apr 02, 2015

You should see the surgeon who did the origional procedure, afterward you may get a second opinion, if you choose.

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Answered by Texas Vein And Cosmetic Specialists

You should see the surgeon who did the origional procedure, afterward you may get a second opinion, if you choose.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Apr 02, 2015

We usually recommend a second opinion if you have concerns. Choose a board certified vascular trains surgeon who specializes in treating varicose veins. He will perform an ultrasound.

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Answered by Vein Specialties of St. Louis

We usually recommend a second opinion if you have concerns. Choose a board certified vascular trains surgeon who specializes in treating varicose veins. He will perform an ultrasound.

Published on Jul 11, 2012


Destin Vein Center

Published on Apr 02, 2015

If you trust your doctor, I would recommend you return and discuss your concerns. You may have a complication or some other new development. If you feel you want to change doctors, be sure to find a vein specialist.

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Answered by Destin Vein Center

If you trust your doctor, I would recommend you return and discuss your concerns. You may have a complication or some other new development. If you feel you want to change doctors, be sure to find a vein specialist.

Published on Jul 11, 2012


Varicose veins are best treated with sclerotherapy or stab phlebotomy, depending on the size.

Answered by Vascular Center and Vein Clinic of Southern Indiana (View Profile)

Varicose veins are best treated with sclerotherapy or stab phlebotomy, depending on the size.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Apr 02, 2015

The question is whether you had any other treatment done in conjunction with your EVLT. A single EVLT is not going to address most people's vein issues. Your vein structure is a network. There are miles of veins in each leg and you could have yards of abnormal veins in each leg. Fixing 1.5 ft of vein in your leg is not going to fix it. You need a comprehensive treatment to address your issues. I would get a 2nd opinion if that is all your doc does.

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Answered by The Sheen Vein Institute

The question is whether you had any other treatment done in conjunction with your EVLT. A single EVLT is not going to address most people's vein issues. Your vein structure is a network. There are miles of veins in each leg and you could have yards of abnormal veins in each leg. Fixing 1.5 ft of vein in your leg is not going to fix it. You need a comprehensive treatment to address your issues. I would get a 2nd opinion if that is all your doc does.

Published on Jul 11, 2012


Vein Specialists of Arizona

Published on Apr 02, 2015

No, it is not normal. You need an ultrasound to determine if there are veins which are not functioning properly (refluxing) causing your swelling. Although EVLT is very successful, there may be other veins that are contributing to your symptoms. Continue to use graduated compression stockings during the day.

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Answered by Vein Specialists of Arizona

No, it is not normal. You need an ultrasound to determine if there are veins which are not functioning properly (refluxing) causing your swelling. Although EVLT is very successful, there may be other veins that are contributing to your symptoms. Continue to use graduated compression stockings during the day.

Published on Jul 11, 2012


Beach Cities Vein and Laser Center

Published on Apr 02, 2015

I would say that you should definitely get a second opinion. It may be that you have another problem that wasn't addressed or that your treatment wasn't completely successful. A good ultrasound at a vein center should help to sort things out. Hope that helps!

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Answered by Beach Cities Vein and Laser Center

I would say that you should definitely get a second opinion. It may be that you have another problem that wasn't addressed or that your treatment wasn't completely successful. A good ultrasound at a vein center should help to sort things out. Hope that helps!

Published on Jul 11, 2012


I believe the next step is to repeat a venous ultrasound duplex to see if the vein has closed adequately or not from the previous EVLT procedure, or if there is an accessory vein that is causing all these symptoms and needs to be treated now. Obtaining a second opinion is always a good option. Hope that helps and hope you get well soon. Good luck!

Answered by Dr. Syed Bokhari M.D., F.A.C.C. (View Profile)

I believe the next step is to repeat a venous ultrasound duplex to see if the vein has closed adequately or not from the previous EVLT procedure, or if there is an accessory vein that is causing all these symptoms and needs to be treated now. Obtaining a second opinion is always a good option. Hope that helps and hope you get well soon. Good luck!

Published on Jul 11, 2012


California Vascular and Vein Center

Published on Apr 02, 2015

You might want to get a second opinion from a vascular specialist.

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Answered by California Vascular and Vein Center

You might want to get a second opinion from a vascular specialist.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Apr 02, 2015

You probably have another refluxing vein that needs closure.

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Answered by Cosmetic Vein Centers of Texas

You probably have another refluxing vein that needs closure.

Published on Jul 11, 2012


More About Doctor California Vein Surgeons

Published on Apr 02, 2015

I think there could be two main reasons for increasing varicosity and swelling in your case. There could be re-canalization of the right leg vein. This could happen in 2-5% of the cases after EVLT. This means your malfunctioning vein is not closed and problems persist or worsen. Second reason could be abnormal connecting veins (perforators) from superficial to deep veins in leg. Other factors include venous high pressure. You should get clinical and duplex venous ultrasound study.

Answered by California Vein Surgeons (View Profile)

I think there could be two main reasons for increasing varicosity and swelling in your case. There could be re-canalization of the right leg vein. This could happen in 2-5% of the cases after EVLT. This means your malfunctioning vein is not closed and problems persist or worsen. Second reason could be abnormal connecting veins (perforators) from superficial to deep veins in leg. Other factors include venous high pressure. You should get clinical and duplex venous ultrasound study.

Published on Jul 11, 2012


The Vein Clinic

Published on Apr 02, 2015

Yes, I always suggest a second opinion to review options prior to any medical procedure .

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Answered by The Vein Clinic

Yes, I always suggest a second opinion to review options prior to any medical procedure .

Published on Jul 11, 2012


North Shore Vein Center

Published on Apr 02, 2015

This is not "normal." You need a repeat ultrasound to determine the cause. If you were happy with the initial doctor, go back and have it there. If you were not, go elsewhere.

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Answered by North Shore Vein Center

This is not "normal." You need a repeat ultrasound to determine the cause. If you were happy with the initial doctor, go back and have it there. If you were not, go elsewhere.

Published on Jul 11, 2012


Yes, I would suggest a second opinion. Make sure you see a true board certified, vascular surgeon/specialist who uses only RVT (registered vascular technologists) in their vascular labs to do a full, functional ultrasound study on your leg, and to truly find out what is happening internally. Hope this helps.

Answered by Advanced Vein & Vascular Center Inc. (View Profile)

Yes, I would suggest a second opinion. Make sure you see a true board certified, vascular surgeon/specialist who uses only RVT (registered vascular technologists) in their vascular labs to do a full, functional ultrasound study on your leg, and to truly find out what is happening internally. Hope this helps.

Published on Jul 11, 2012


NE Laser Vein Institute LLC

Published on Apr 02, 2015

Are these veins exactly the same as before? If not, then you have new varicose veins, which is normal. Please do get a second opinion.

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Answered by NE Laser Vein Institute LLC

Are these veins exactly the same as before? If not, then you have new varicose veins, which is normal. Please do get a second opinion.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Apr 02, 2015

This is not normal. If new varicose veins have formed, this suggests that there are open valves somewhere – either new or old and since you are still having leg problems, it would be important to repeat the venous ultrasound to see where the problem lies. See a vein specialist.

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Answered by Vanish Vein and Laser Center

This is not normal. If new varicose veins have formed, this suggests that there are open valves somewhere – either new or old and since you are still having leg problems, it would be important to repeat the venous ultrasound to see where the problem lies. See a vein specialist.

Published on Jul 11, 2012


Georgia Vascular Institute

Published on Apr 02, 2015

You should probably be re-evaluated with an ultrasound to see if the closed vein has reopened. Also, there can be underlying perforator veins, which can cause problems.

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Answered by Georgia Vascular Institute

You should probably be re-evaluated with an ultrasound to see if the closed vein has reopened. Also, there can be underlying perforator veins, which can cause problems.

Published on Jul 11, 2012

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