It is important to find a physician who is competent and has integrity, i.e., is treating veins that are insufficient and need to be treated. I suggest that you consult with several physicians and obtain their treatment recommendations. Every physician with whom you consult should discover the same findings and have comparable treatment recommendations. If there is a disparity in findings and recommendations between the physicians, you should seek additional guidance. Once you are certain that you have been correctly diagnosed and that the treatment plan is correct, you should choose a physician with whom you have the most confidence and comfort.

Published on Jul 11, 2012

I would recommend a consultation with a board certified vascular trained surgeon who can perform these in his office under local anesthesia. Someone with many years of experience is advisable. We do see many people for second opinions after they were told they needed so many procedures and find they really do not.

Published on Jul 11, 2012

Although uncommon (success rate is >96%), it is possible even with the most qualified provider, that thermal vein closure fails. Although disappointing, it does not necessarily mean that you need to find someone else. There is not a specific board that regulates just vein practices. However, there are organizations such as the American College of Phlebology and the American Venous Forum which guide most providers. Additionally, like all professions there are review sites. Finally, you will want to choose someone you are comfortable with and who addresses your concerns in a manner that suits you. Not all providers are created equally.

Published on Jul 11, 2012

Seeing a top vein doctor, who you can trust, would be ideal. It is important that an evaluation of your venous circulation is done by a Vein Doctor that is Board Certified, preferably by the American Venous and Lymphatic Board of Medicine. Using ultrasound imaging to scan your leg(s), the vein doctor can decide what the best vein treatment plan would be for your specific case after knowing all your signs and symptoms, anatomical variations, pathology, and reflux time.
All the best!

Published on Jul 11, 2012

No you should not consider another doctor. Sometimes this can happen It can reopen on it's own if the vein diameter is to large. You might just need to have another treatment.

Published on Jul 11, 2012

The treatment of veins has evolved over the last 20 years as has the qualifications of the physicians who treat veins. There is a board certification in venous treatments called the American Board of Venous and Lymphatic Medicine. Physicians who have passed this qualifying exam are fully credentialed to treat venous disease. If you go to this website you will be able to find a board qualified vein physician.

Published on Jul 11, 2012

It is pretty rare that the VNUS does not close the saphenous vein. Occasionally, particularly with horrible veins like yours, the vein was large and failed to respond to the energy dose used. In cases like that, we would re treat at a higher energy, and this will typically work fine. It is one of those things that just happens from time to time, and doesn't put your health at risk.

Published on Jul 11, 2012

This is a difficult question. In general you would like to see some certification related to the treatment of vein disease, such as Vascular Surgery or Phlebology. It is recommended to be seen in a center that has accreditation (by the IAC) as a Vein Center and as a Vascular Laboratory. You would also appreciate seeing some of the before and after pictures from that specific practice and have an idea of how many such procedures they have done.

I become very concerned when I see such an extensive number of procedures that appear in the original plan, irrespective of the amount of disease that you have. I have been managing Vein Disease for over 20 years. I have performed over 2500 ablation procedures. It is only a rare patient that has required 4 different ablations. I have not had any patient who needed 5 ablations. Before proceeding with 5 ablations (in your case, now 6 ablations, including a redo procedure), I would get a second opinion. I hope that this extensive answer helps you make the right decision.

Published on Jul 11, 2012