You should be evaluated for clotting issues by a hematologist since you have strong a family history. The majority of the clots responsible for stroke develop in the arteries and heart. If someone has an opening between right and left side of the heart, then venous clot may go to the arterial supply to the brain. Laser and injection treatments do have higher risks of clot extension. These clots are responsible for pulmonary embolism and list likely stroke, except if the patient has an opening in right to left in the heart.

Published on Jul 11, 2012

An ultrasound of your legs is typically performed during a vein consultation that will allow your physician to determine if your protruding veins are truly varicose veins and a result of venous insufficiency that can be treated. A family history of deep vein thrombosis or pulmonary embolism can be a sign of an underlying clotting abnormality, but does not usually require testing unless you have a personal history of blood clots. The risk of DVT with endovenous laser is very low and close to 1%.

Published on Jul 11, 2012

You need to have an evaluation of the venous system at a vein center dedicated exclusively to vein care.

Published on Jul 11, 2012

Stripping isn't used anymore. Laser treatments are the norm. See a vein specialist to answer your questions.

Published on Jul 11, 2012

Serious problems with blood clots almost always originate in the veins below the muscles. The veins that you can see are always above the muscles. An ultrasound can tell the doctor if problems exist in the deep veins (below the muscles). In the vast majority of cases, visible veins on the shins and feet do not involve problems with the deep veins. Forget stripping as that is a big operation and almost no one does that anymore. Find a vein specialist that you like and trust, and relax as these are usually low risk and fairly simple procedures. Blood tests can be done in advance to determine if you inherited a predisposition that makes you prone to develop blood clots too easily.

Published on Jul 11, 2012

The veins on your hands and feet are not varicose veins. Veins on your shins may be varicose if the venous valves are leaking in the saphenous or perforating veins of your leg. Vein stripping is much more dangerous than endovenous laser treatment. Deep vein clot is more likely with vein stripping. You need to be evaluated by a hematologist if you think you may have clotting problems before any surgery.

Published on Jul 11, 2012

There is generally very low risk for clotting after these procedures. You can ask your MD, however, to check for hypercoaguability problems.

Published on Jul 11, 2012

Yes, laser and injection treatments are less conducive to clotting but still have a risk. You should be tested (thrombophilia screen) to
determine if you are carrying a gene for clotting. If so, you should receive prophylactic anticoagulation for your outpatient vein procedures.

Published on Jul 11, 2012

Unfortunately, when it comes to treating veins, board certification can be confusing. It matters in what area of specialization your doctor holds boards. Also, not all boards are recognized by the American Specialty Board.
Also, strokes and pulmonary embolism are two different disease processes. And blood clots resulting from procedures are uncommon, whether the vein is removed surgically, injected, or treated with laser.

Published on Jul 11, 2012

You are correct that all protruding veins are not varicose. Varicose veins are generally more irregular in shape than normal veins and are more likely to be colored and surrounded by areas of discoloration in the skin surrounding them.

In general catheter related therapies are safe with very low rates of associated clotting. Before any treatment I would suggest a complete hyper coagulation evaluation to assess your true risk of clot formation regardless of vein treatment.

Dr. Harlin

Published on Jul 11, 2012

You are correct that all protruding veins are not varicose. Varicose veins are generally more irregular in shape than normal veins and are more likely to be colored and surrounded by areas of discoloration in the skin surrounding them.

In general, catheter related therapies are safe with very low rates of associated clotting. Before any treatment I would suggest a complete hyper coagulation evaluation to assess your true risk of clot formation regardless of vein treatment.

Dr. Harlin

Published on Jul 11, 2012

You are correct that all protruding veins are not varicose. Varicose veins are generally more irregular in shape than normal veins and are more likely to be colored and surrounded by areas of discoloration in the skin surrounding them.

In general, catheter-related therapies are safe with very low rates of associated clotting. Before any treatment, I would suggest a complete hyper coagulation evaluation to assess your true risk of clot formation, regardless of vein treatment.

Published on Jul 11, 2012

That is a very good question. The incidence of DVT (deep vein thrombosis, or blood clot in the deepleg veins) is about 1% with endovenous ablation (laser or radiofrequency). The incidence of DVT with sclerotherapy injections is VERY low, 0.1% or less. If you have a known medical condition that pre-disposes you to developing blood clots ("hypercoagulable" conditions), then you may be at a higher risk. Stripping has a higher risk of DVT because it requires bed rest for a while.

Published on Jul 11, 2012

Your doc should be able to tell you whether your vein is abnormal. Normally this is done by ultrasound evaluation of the affected vein and the leg. Everyone needs an ultrasound prior to any vein evaluation. If you did not get one, that doc is not who you want to go to. Otherwise your risk of blood clots normally is about 50x less with treatment than if you left them alone. I would also never have a stripping procedure done. It is unnecessary today. There are better ways to treat them.

Published on Jul 11, 2012