Outcomes with Microphlebectomy/EVLT?

I have dorsal foot varicosities, as well as varicose GSV and LSV's receiving these veins. Has anyone done microphlebectomy of the foot veins (with/out EVLT) and had more good than bad experiences with this procedure here? Thank you!

ANSWERS FROM DOCTORS (5)


2 weeks ago by Vein Center for Women PC

EVLT is a definitive procedure using laser heat delivered to the inner wall of the vein that is causing the reflux in the leg, and closing those veins to stop the reflux causing varicose veins. Your foot veins are part of the pedal arch and drains into these veins, and when these veins are closed they will find alternate routes for connecting to the venous system. I generally recommend to my patients not to touch the foot veins. If there are some vein clusters caused by long standing varicose veins they can be treated later after at least 3-4 weeks after correcting the reflux first. You will be surprised to see the improvement you will see just with correcting reflux with laser or RF or clarivein-any method used to correct reflux.

You may not have to do anything to the foot veins. Generally when foot veins are treated with sclerotherapy, you will see new veins pop up as time goes on. So with regard to foot veins you have to be selective and careful. As I said, most of the time none may be needed or minimal. Patience is needed when you are having varicose veins treated. It may be a few more visits in follow up and may be a few copays more, but you will get much better results waiting to see how your body reroutes the circulation after a vein is closed through other normal veins, and how decreasing venous pressure in the leg after correcting reflux alone makes many of the existing veins appear a lot better. After all, most of the patients had the condition for years and did not seek treatment, but now suddenly you get impatient, you want results overnight.

My advice: do the reflux correcting EVLT first. If it is GSV and SSV do them first. Then wait for a month or two. Then reevaluate for yourself what veins in your foot still appear not normal for you. May be there is a perforator vein which needs to be treated. So go for follow up evaluations with your vein surgeon and follow their recommendation. Thank you for this opportunity.

2 weeks ago by Vein Center for Women PC (View Profile)

EVLT is a definitive procedure using laser heat delivered to the inner wall of the vein that is causing the reflux in the leg, and closing those veins to stop the reflux causing varicose veins. Your foot veins are part of the pedal arch and drains into these veins, and when these veins are closed they will find alternate routes for connecting to the venous system. I generally recommend to my patients not to touch the foot veins. If there are some vein clusters caused by long standing varicose veins they can be treated later after at least 3-4 weeks after correcting the reflux first. You will be surprised to see the improvement you will see just with correcting reflux with laser or RF or clarivein-any method used to correct reflux.

You may not have to do anything to the foot veins. Generally when foot veins are treated with sclerotherapy, you will see new veins pop up as time goes on. So with regard to foot veins you have to be selective and careful. As I said, most of the time none may be needed or minimal. Patience is needed when you are having varicose veins treated. It may be a few more visits in follow up and may be a few copays more, but you will get much better results waiting to see how your body reroutes the circulation after a vein is closed through other normal veins, and how decreasing venous pressure in the leg after correcting reflux alone makes many of the existing veins appear a lot better. After all, most of the patients had the condition for years and did not seek treatment, but now suddenly you get impatient, you want results overnight.

My advice: do the reflux correcting EVLT first. If it is GSV and SSV do them first. Then wait for a month or two. Then reevaluate for yourself what veins in your foot still appear not normal for you. May be there is a perforator vein which needs to be treated. So go for follow up evaluations with your vein surgeon and follow their recommendation. Thank you for this opportunity.


5 years ago by Bella MD Laser Vein and Aesthetic Center

If GSV refluxing it needs to be fixed first.

5 years ago by Bella MD Laser Vein and Aesthetic Center

If GSV refluxing it needs to be fixed first.


5 years ago by General Vascular Surgery Group

Not recommended. One should treat the source veins first or simultaneously with the microphlebectomies.

It's important to treat the underlying problem first.

Michael D. Ingegno

5 years ago by General Vascular Surgery Group

Not recommended. One should treat the source veins first or simultaneously with the microphlebectomies.

It's important to treat the underlying problem first.

Michael D. Ingegno


5 years ago by Vein Specialties of St. Louis

Firstly you should have a full evaluation with ultrasound to assess if there is underlying reflux in the saphenous veins and a patent deep system. If there is, then EVLT is the appropriate treatment to seal the saphenous veins. I typically do one vein per setting to allow to the leg to recover. I will, however do phlebectomies at the same setting. Bulging dorsal foot veins may shrink after the sealing of the refluxing (back flow) saphenous veins. Statistically 50% may but not always. These can be treated later by phlebectomy if causing discomfort in the shoes etc. These should be done by an experienced surgeon as there are a lot more nerves in the area. I also do many of these cosmetically for patients who don't like the appearance of large veins over the feet. I only do half the foot per treatment.

5 years ago by Vein Specialties of St. Louis (View Profile)

Firstly you should have a full evaluation with ultrasound to assess if there is underlying reflux in the saphenous veins and a patent deep system. If there is, then EVLT is the appropriate treatment to seal the saphenous veins. I typically do one vein per setting to allow to the leg to recover. I will, however do phlebectomies at the same setting. Bulging dorsal foot veins may shrink after the sealing of the refluxing (back flow) saphenous veins. Statistically 50% may but not always. These can be treated later by phlebectomy if causing discomfort in the shoes etc. These should be done by an experienced surgeon as there are a lot more nerves in the area. I also do many of these cosmetically for patients who don't like the appearance of large veins over the feet. I only do half the foot per treatment.


6 years ago by Vanish Vein and Laser Center

I have treated dorsal foot veins frequently with both microphlebectomies and sclerotherapy with excellent results. Sometimes it is done in association with a closure procedure and sometimes independent of a closure procedure.

6 years ago by Vanish Vein and Laser Center (View Profile)

I have treated dorsal foot veins frequently with both microphlebectomies and sclerotherapy with excellent results. Sometimes it is done in association with a closure procedure and sometimes independent of a closure procedure.


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