What are the signs of hematoma after ambulatory phlebectomy and EVLT? Also, what would cause a burning sensation during an ultrasound recheck?

I experienced severe bruising and intense pain 8 days after ambulatory phlebectomy and EVLT. I could not even touch the area from my right groin all the way down to my knee. I followed all of the doctor's orders given post-op. Upon a recheck yesterday, no infection was found, but during the ultrasound the pain upon the docs pressing the area was excruciating and I felt a burning sensation go all the way up leg. What's going on? Could I have a hematoma?

Answers from doctors (5)


Vanish Vein and Laser Center

Published on Feb 10, 2020

One of the most common patient complaints post EVLT or other closure procedures is pain along the treated saphenous vein from the groin to the knee. This typically is worse about 5 to 7 days post-treatment because during this time the tumescent anesthesia resolves and the vein is in the process of contracting so the discomfort increases. Moist heat to the area and ibuprofen will help. Try this for the next week and, if no improvement, then follow up again with your treating physician.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1053_1499982262.jpg
Answered by Vanish Vein and Laser Center

One of the most common patient complaints post EVLT or other closure procedures is pain along the treated saphenous vein from the groin to the knee. This typically is worse about 5 to 7 days post-treatment because during this time the tumescent anesthesia resolves and the vein is in the process of contracting so the discomfort increases. Moist heat to the area and ibuprofen will help. Try this for the next week and, if no improvement, then follow up again with your treating physician.

Published on Jul 11, 2012


Advanced Vein Center

Published on Sep 25, 2015

I have done thousands of these procedures and the only thing that comes to mind is a spontaneous clotting of a branch vein from the vein that was treated, and this can hurt but is not a problem and probably a "bonus" because it was a vein that might have had to be treated later. Pressure with the ultrasound probe would make it more painful.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/464_1408044069.jpg
Answered by Advanced Vein Center

I have done thousands of these procedures and the only thing that comes to mind is a spontaneous clotting of a branch vein from the vein that was treated, and this can hurt but is not a problem and probably a "bonus" because it was a vein that might have had to be treated later. Pressure with the ultrasound probe would make it more painful.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Sep 25, 2015

Without examining you, I would say that you most likely have deeper swelling and inflammation resolving (typically 10 -14 days) when nerves become sensitive. Some slight increase in discomfort at this stage isn't uncommon. However, if larger nerves are not adequately protected (local anesthesia during the procedure), this can cause more pain. You unlikely have a hematoma. I would recommend local low heat as often as possible, take Advil every 8 hours with food, and gently massage the areas with arnica or Dermaka cream. It will be tender to begin with but will improve and desensitize the nerves, and you can gradually apply more pressure as inflammation resolves. Wearing compression hose can also increase comfort when moving.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/623_1499902138.jpg
Answered by Vein Specialties of St. Louis

Without examining you, I would say that you most likely have deeper swelling and inflammation resolving (typically 10 -14 days) when nerves become sensitive. Some slight increase in discomfort at this stage isn't uncommon. However, if larger nerves are not adequately protected (local anesthesia during the procedure), this can cause more pain. You unlikely have a hematoma. I would recommend local low heat as often as possible, take Advil every 8 hours with food, and gently massage the areas with arnica or Dermaka cream. It will be tender to begin with but will improve and desensitize the nerves, and you can gradually apply more pressure as inflammation resolves. Wearing compression hose can also increase comfort when moving.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Sep 25, 2015

The discomfort you are feeling can be due to a few things. The first thing is that you have a lot of inflammation in the treated vein. This inflammation can irritate the nerve endings running along the vein, resulting in the burning and tingling. The second reason is that since the leg started hurting days later, you probably have one or both of the following: 1. Trapped blood that is pocketed in the treated vein. This blood only irritates an already inflamed vein to make it hurt even more. 2. You could have branches trying to feed into your now closed vein. The result is pressure spots that can cause either trapped blood and resultant pain, or just intense pressure pain. Your docs should just need to go in and treat those spots and/or trapped blood. The pain goes away rather quickly. If your docs do not know how to do this, then you unfortunately went to the wrong vein docs. Skilled vein docs know how to fix this and do so every day.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1116_1499984661.jpg
Answered by The Sheen Vein Institute

The discomfort you are feeling can be due to a few things. The first thing is that you have a lot of inflammation in the treated vein. This inflammation can irritate the nerve endings running along the vein, resulting in the burning and tingling. The second reason is that since the leg started hurting days later, you probably have one or both of the following: 1. Trapped blood that is pocketed in the treated vein. This blood only irritates an already inflamed vein to make it hurt even more. 2. You could have branches trying to feed into your now closed vein. The result is pressure spots that can cause either trapped blood and resultant pain, or just intense pressure pain. Your docs should just need to go in and treat those spots and/or trapped blood. The pain goes away rather quickly. If your docs do not know how to do this, then you unfortunately went to the wrong vein docs. Skilled vein docs know how to fix this and do so every day.

Published on Jul 11, 2012


Destin Vein Center

Published on Sep 25, 2015

Yes, it does sound like a painful hematoma.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/927_1422310261.jpg
Answered by Destin Vein Center

Yes, it does sound like a painful hematoma.

Published on Jul 11, 2012


Related Questions for Ambulatory Phlebectomy

Ambulatory Phlebectomy -4 answers
I had ambulatory phlebectomy performed on my leg two weeks ago. How long will it take for the incisions to heal? Right now the incisions look like little red scabs.
See More
Ambulatory Phlebectomy -10 answers
I am scheduled for ambulatory phlebectomy and laser ablation in a week. I also have several 5K runs soon and a two-week beach vacation in June. How soon before I would be able to exercise and run again after these procedures? How long to stay out of the sun?
See More
Ambulatory Phlebectomy -3 answers
I had ambulatory phlebectomy with ligation 6 weeks ago and my leg still has shooting pains at times and I've got this painful bump on my inner thigh that won't go away. Sometimes the swelling (maybe a vein) spreads up the thigh (painful). Any ideas?
See More
Ambulatory Phlebectomy -6 answers
I just had a phlebectomy done at 3pm, and have increasing pain and throbbing.Norco and Ibuprofen are not doing much! I have been elevating my leg and icing it to help with the pain, but it's not getting better. I walked around for short periods, with no relief. Is something wrong?
See More
Ambulatory Phlebectomy -8 answers
I had my microphlebectomy procedure 12 days ago, and I've had minimal pain since the initial 48 hours post surgery. However, I stopped wearing my compression stocking 2 days ago and now have pain when I walk and darker bruising. Should I be overly concerned?
See More
Ambulatory Phlebectomy -3 answers
A friend of mine had ambulatory phlebectomy and now her leg is scarred from about 50 little incisions that never really healed. Everything online says "minimal" scarring, but is that really true? It wasn't in her case and I don't know why. Do you have any idea?
See More
Ambulatory Phlebectomy -7 answers
I had a microphlebectomy below my knee and radiofrequency ablation above on the same leg on the same day. Now, I have neuropathy in that leg from mid-calf to nearly my groin. It's been one month. Are stockings contraindicated with neuropathy?
See More
Ambulatory Phlebectomy -6 answers
I have varicose veins and spider veins and one burst in back of knee. The bruise has doubled in size in a 24 hour time period. What should I do? Do I need a consult and, if so, which type of specialist?
See More
Ambulatory Phlebectomy -6 answers
I had ambulatory phlebectomy 7 weeks ago to remove some veins under my foot. I have a small pea-sized hard lump under one scar. It doesn't seem to hurt. Is this something to be concerned about? I will have a follow-up with my doctor next month.
See More
Get answers from our experienced doctors.
How it works
Ambulatory Phlebectomy -6 answers
The first night I slept with my leg wrapped with bandage. The next day I took them off and I have been wearing compression stockings, but I'm not sure if I have to sleep with them. It is a little uncomfortable to sleep with them.
See More
Ambulatory Phlebectomy -14 answers
I underwent ambulatory phlebectomy for my right leg. No visible veins on left. I'm always standing at work (8-12 hrs).
See More
Ambulatory Phlebectomy -8 answers
I'm 25 and have had varicose veins since I was 17. I have started to get more noticeable varicose veins with more discomfort. I used to be a runner, but now I fatigue quite easily. What options could I look at to help me minimize them or get rid of them?
See More
Ambulatory Phlebectomy -5 answers
I had an ablation and microphlebectomy done on my right leg Friday. I put compression hose on Sunday. I still have swelling in my foot. The swelling is where the ace wrap stopped about an inch from my toes. I've been walking as much as possible and elevating it when I sit. Is that normal?
See More
Ambulatory Phlebectomy -3 answers
I have some hyper pigmentation on one of my legs after having ambulatory phlebectomy and endovenous laser ablation. What topical treatment can I use to help fade this hyperpigmentation? Or should I just give it time to fade?
See More
Ambulatory Phlebectomy -4 answers
I had a surgery to remove varicose veins in my thigh and now two months later, I feel a pain in my calf and I see a lump. It hurts so much. Is this normal? What should I do?
See More
Ambulatory Phlebectomy -4 answers
My Dr discussed EVLA and Sclerotherapy. Now, my paperwork mentions EVLA, Deep Sclerotherapy, and Phlebectomy are approved by insurance. I was told that this is just a back up procedure, but I am uncomfortable with the seemly casual addition of taking out veins.
See More
Ambulatory Phlebectomy -8 answers
Over the past 3 years I was diagnosed with insufficient circulation due to weakened veins. The doctors told me there was no medicine and that the only alternatives are compression stockings or an ambulatory phlebectomy. Is an ambulatory phlebectomy necessary or would compression stockings work just as well?
See More
Ambulatory Phlebectomy -4 answers
I have type 2 diabetes that is not well controlled (hba1c is 11). I'm having radiofrequency ablation & a stab phlebectomy. I'm concerned about anesthesia and wound healing. What are the risks based on my condition?
See More
Get answers from our experienced doctors.
How it works

Related Articles

Have specific questions?
ASK A DOCTOR