I'm a 33 year old woman and have had Evla treatment 6 weeks ago. I’ve been told to wear compression stockings forever, will this help remaining veins?
I have varicose veins and spider veins on my left leg, they are quite bad, especially in my foot. I have had Evla and I think it's helped a bit but the surgeon I've seen isn't happy there are still some remaining. He told me I would have to wear compression stockings for the rest of life, which at 33 years old is hard to take in. I have no pain from them. I am not overweight and I exercise regularly. Is this recommendation realistic, and 'normal' practice. I feel so down and anxious.
Answers from doctors (11)
If EVLA were your only option, you would probably be stuck wearing compression stockings for the rest of your life.
Fortunately many of us phlebologists perform multiple different therapies, either separately or at the same time. We see patients with your dilemma commonly. This problem is nearly always correctable.
EVLA is the acronym Endovenous Laser Ablation. This is used for the process of eliminating (destroying) a varicose vein, usually the Great Saphenous Vein(s). The heat of the laser is utilized to destroy the malfunctioning vein and hopefully return proper blood flow to the effected area(s). The hope is that all of the "down stream" problems resolve as well. Sometimes this does the whole job. Sometimes times it does not.
The first step in correcting this problem is to perform a complete venous ultrasound evaluation of blood flow to identify the location(s) of incompetent veins. After locating the problem(s), I have found treatment using sclerotherapy in these scenarios to be most rewarding. This procedure usually improves or corrects your complaints. I rarely see the necessity of compression stockings after the initial healing stages.
Published on Jul 11, 2012
The goal of EVLA is to eliminate reflux so that the patient will not have to wear stockings indefinitely. If your venous insufficiency is confined to the superficial system, this is a realistic goal. If you also have deep venous insufficiency, stockings may be advisable.
A thorough lower extremity duplex ultrasound exam should provide the answer to your query. Should you have only superficial vein problems and your surgeon is unable to help further, I suggest a second opinion from a qualified vein specialist who can probably perform an ultrasound at your consultation.
Published on Jul 11, 2012
They can easily be treated with sclerotherapy or phlebectomy.
Published on Jul 11, 2012
I suggest you seek another opinion from a specialist who can examine you. Make sure they are a member or fellow in the American College of Phlebology and Board certified in American Board of Venous and Lymphatic Disease.
Published on Jul 11, 2012
If the only treatment that you received from your doc was the EVLA, then you really only had about 5% of your vein issues treated. The ropey and spider veins do not go away with only EVLA. So it does not surprise me that they did not go away. In fact, nothing goes away until you treat it. Think stretched out balloon. Even without air in it, the balloon never returns to normal size. Your veins do not either. Wearing stockings does nothing for you as well other than symptomatic help. Find a doc who knows how to treat "all" of your vein issues.
Published on Jul 11, 2012
You need a reflux study venous ultrasound to determine if there are other veins that can be treated to relieve your symptoms and what you see- ie: sclerotherapy, graduated compression hose will help with how you feel but will not correct any abnormal veins
Published on Jul 11, 2012
In all likelihood, you've been given some inaccurate information. After EVLA there may indeed be some visible residual varicose veins - these are usually easily treated (depending on size and location) by an adjunctive procedure such as microphlebectomies or ultrasound guided foam sclerotherapy. When in doubt, get a second opinion. In most circumstances you would not need to wear compression stockings once all treatments and recovery are complete.
Published on Jul 11, 2012
Spider veins and varicose veins can be improved by sclerotherapy and stab phlebectomy, respectively. Wearing compression stockings will provide symptomatic.
Published on Jul 11, 2012
I tell patients to wear compression hose for 2 days post closure procedures or sclerotherapy. Any remaining veins can be treated by sclerotherapy. The concept of wearing support hose forever makes sense if you are in a cool environment and if it is feasible to do. You are doing the right things for your legs by keeping fit and exercising. Periodically veins will occur with or without support hose and you can treat them as necessary.
Published on Jul 11, 2012
You can have sclerotherapy or microphlebectomies to remove the remaining veins depending on the size. Since you have "bad veins" at a fairly young age, you are prone to getting more veins throughout your life. Compression hose help your symptoms but wont help the veins go away. I would consider a second opinion to see if you have deep insufficiency or just superficial insufficiency and to see if more veins can be treated to make you happier.
Published on Jul 11, 2012
If you have residual varicose veins they can be dealt with by microphlebectomy if larger or sclerotherapy if smaller or spider veins. If asymptomatic there really is no reason to wear hose. However, if you work standing, travel a lot or plan on pregnancy we do recommend hose. Your lifestyle is also beneficial. If your surgeon doesn't do theses procedures (they are considered cosmetic) seek a vein center which specializes in these treatments.
Published on Jul 11, 2012
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