Medically treating superficial venous reflux means that blood will be rerouted to the healthy veins to prevent blood from pooling in the legs. Pooling is what forms varicose veins and leads to many other signs and symptoms like leg swelling, leg pain, leg cramps, leg heaviness, burning sensation or itching of the skin, and changes like venous ulcers or sores.

Options to treat reflux of the superficial veins include EVLT, RFA, and Venaseal. Also, there is guided sclerotherapy and ambulatory phlebectomy for tributary veins that remain open next to the skin after closure treatment of the superficial veins that show reflux.

It is recommended you have an evaluation with the vein specialist and ultrasound of your legs, as well as careful evaluation of your medical history to make sure you are a candidate for treatment. Also, conservative management is recommended to help with symptoms in the meantime. See a vein specialist.

All the best!

You should see a vein specialist for a full venous evaluation. He/She can determine if a closure procedure can help you. A hyper coagulable state is not a contraindication to a closure procedure.

I would not do a closure if you have a hypercoaguable state and a history of clots in your deep veins. You most likely have post-phlebitic syndrome from the clots in the past and the clots damaging the deep vein valves. The recommendation is wearing compression hose, elevating your leg at night and good foot care to prevent any cracks or sores that could lead to infection if your leg is swelling. You should see a vascular specialist.

Depending on your hypercoagulable diagnosis and thus risk, as well as Doppler/ultrasound (Duplex) findings, you may be a candidate for closure or other treatments. Some patients undergo endoluminal ablation (RF or laser) while receiving DVT prophylaxis (Lovenox). You should consult your vein specialist and get a formal hematologic evaluation before ANY treatment is considered. Avoid vein centers that frequently train non- vascular surgeons, gynecologists, radiologists, etc.

A duplex ultrasound of your legs will answer the question. There is no other way to know. Your prior surgeries, hyper coag state, etc does not help answer the question. You may also need a CT venogram of your leg and pelvis and a lymphoscintigraphy study to rule out other causes of swelling.

Since you are a complicated patient, I suggest that you go to a doctor that specializes in varicose vein surgeries. His/her evaluation will help determine what procedure is best for you. Closure (RF) or