If both superficial veins are successfully closed based on ultrasound and you have a recurrence of symptoms, you could possibly have issues with your deep venous system. There is an anatomic condition that typically causes one-sided leg swelling called May-Thurner syndrome. This can be checked with an iliac vein ultrasound, not done at all ultrasound labs, to evaluate for narrowing of the vein or abnormal flow patterns. If present and symptoms are lifestyle-limiting, a stent can be placed in the vein to allow better drainage of the leg and decrease swelling.

Published on Jul 11, 2012

It could be lymphedema, a rare side effect of the procedure. It could be that you developed a blood clot higher up or that something is compressing the vein. I would consider a pelvic CT scan with and without contrast to evaluate and rule out other causes of leg swelling.

Published on Jul 11, 2012

I would not have recommended ablations in the setting where patient do not have symptoms (e.g. present only with cosmetic concerns).

Published on Jul 11, 2012

If the swelling developed after the ablation procedures, one would have to assume that the swelling is due to the procedures. That said, the swelling in that case is probably secondary to one of two things. First, the fact that when your cardiologist ablated your saphenous veins, he neglected to address the remainder of your refluxing veins. The result is a persistent sub-optimal venous circulation that was apparently made worse by your ablation procedures. In my experience, the only time that happens is when the doc ablates the saphenous veins without realizing that a large part of the vein that they are actually ablating is normal. Unfortunately, cardiologists are not specialists in vein treatments. Many non-vein specialists will use the ultrasound and only look at a couple of spots along the length of the saphenous vein. If these 2-3 areas are refluxing then they have a tendency to just ablate the entire vein. Unfortunately, those areas that they do not check can still be normal. Therefore, when they ablate the whole vein, 90% of what they ablate may in fact be normal. It is just that they do not know that it is normal because they did not know to look. When you take out normal vein structure, especially of the magnitude of the saphenous veins, you can cause leg swelling. Furthermore, it does not sound like your doc ever addressed the remainder of your vein issues( you have more than just 1-2 veins that are going to be abnormal). True docs will fix the whole leg in order to fix the venous circulatory defect that comes along with vein disease. Vein issues are not the cosmetic issue that people think it is. Veins return blood back to the heart. Any defect in them can never be a "cosmetic" issue. Look for a real vein doc and see if they can repair what has already been done.

Published on Jul 11, 2012