Why am I still experiencing swelling more than two years after EVLA?

I had the endovenous laser ablation procedure over two years ago. Initially there was some swelling, but it improved with compression hose. I no longer wear the hose and today I measured my leg. The portion from my knee down is swollen and the rt one is 2 inches bigger. Why am I still experiencing swelling?

Answers from doctors (16)


The Sheen Vein Institute

Published on Mar 29, 2013

Swelling in the legs can be caused by many things, ranging from heart failure to kidney issues to vein issues. In order to determine why you are swelling, you really need to have an ultrasound performed on your legs first. The ultrasound will enable the doc to see how your venous circulation is working and if there are flow problems that might be the source of your swelling. Without this information, any diagnosis regarding why you have swelling would only be speculation.

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Answered by The Sheen Vein Institute

Swelling in the legs can be caused by many things, ranging from heart failure to kidney issues to vein issues. In order to determine why you are swelling, you really need to have an ultrasound performed on your legs first. The ultrasound will enable the doc to see how your venous circulation is working and if there are flow problems that might be the source of your swelling. Without this information, any diagnosis regarding why you have swelling would only be speculation.

Published on Jul 11, 2012


Americas Vein Centers - Southborough

Published on Mar 21, 2013

It is hard to make a prediction without evaluating the leg first. You need to consult with the physician who performed the treatment or seek the assistance of a new vein surgeon.

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Answered by Americas Vein Centers - Southborough

It is hard to make a prediction without evaluating the leg first. You need to consult with the physician who performed the treatment or seek the assistance of a new vein surgeon.

Published on Jul 11, 2012


Advanced Vein Center

Published on Mar 19, 2013

It is rare to have complaints this far out after endovenous laser ablation (EVLA). You should see the doctor who performed the treatment or get a second opinion. This would include a complete duplex ultrasound of your legs.

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Answered by Advanced Vein Center

It is rare to have complaints this far out after endovenous laser ablation (EVLA). You should see the doctor who performed the treatment or get a second opinion. This would include a complete duplex ultrasound of your legs.

Published on Jul 11, 2012


Vein Specialists

Published on Mar 19, 2013

I advise you to see your vein specialist again and consider another venous insufficiency study to see if anything new has opened up.

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Answered by Vein Specialists

I advise you to see your vein specialist again and consider another venous insufficiency study to see if anything new has opened up.

Published on Jul 11, 2012


Vein 911

Published on Mar 18, 2013

You may have been incompletely treated, which is not uncommon. Almost all patients require ancillary procedures (such as ultrasound guided sclerotherapy and/or phlebectomy) after EVLA. Sometimes, however, these ancillary procedures are not offered to the patient or are poorly performed. A new baseline ultrasound is suggested. This will likely reveal the source behind the "leaking" vein.

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Answered by Vein 911

You may have been incompletely treated, which is not uncommon. Almost all patients require ancillary procedures (such as ultrasound guided sclerotherapy and/or phlebectomy) after EVLA. Sometimes, however, these ancillary procedures are not offered to the patient or are poorly performed. A new baseline ultrasound is suggested. This will likely reveal the source behind the "leaking" vein.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Mar 18, 2013

If there was swelling present prior to your EVLA, there is a possibility that there is another underlying cause. There is no way to know if the swelling is a direct result of your saphenous insufficiency. I recommend you be thoroughly evaluated by an experienced vascular surgeon. An ultrasound test can rule out any blood clot or determine if another vein is refluxing. I would also recommend this be done immediately. In the meantime, try putting your hose on before you get out of bed in the morning and wear them all day until you are evaluated.

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Answered by Vein Specialties of St. Louis

If there was swelling present prior to your EVLA, there is a possibility that there is another underlying cause. There is no way to know if the swelling is a direct result of your saphenous insufficiency. I recommend you be thoroughly evaluated by an experienced vascular surgeon. An ultrasound test can rule out any blood clot or determine if another vein is refluxing. I would also recommend this be done immediately. In the meantime, try putting your hose on before you get out of bed in the morning and wear them all day until you are evaluated.

Published on Jul 11, 2012


Arizona Vein Specialists

Published on Mar 18, 2013

You must follow up with your doctor or another vein specialist for a duplex ultrasound to determine the cause of the swelling.

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Answered by Arizona Vein Specialists

You must follow up with your doctor or another vein specialist for a duplex ultrasound to determine the cause of the swelling.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Mar 18, 2013

It is difficult to answer this question. The swelling could be completely unrelated to the laser ablation. You need a full work-up, including a repeat venous ultrasound and a review of your medications. The latter is relevant since there are many medications that can contribute to swelling. Other things, such as a popliteal cyst, an old deep vein thrombosis, or lymphedema can be contributing factors. You should follow up with a vascular surgeon.

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Answered by Vanish Vein and Laser Center

It is difficult to answer this question. The swelling could be completely unrelated to the laser ablation. You need a full work-up, including a repeat venous ultrasound and a review of your medications. The latter is relevant since there are many medications that can contribute to swelling. Other things, such as a popliteal cyst, an old deep vein thrombosis, or lymphedema can be contributing factors. You should follow up with a vascular surgeon.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Mar 18, 2013

Your leg swelling is probably caused by another problem (most likely lymphedema), but there are many other reasons why the swelling could be occurring. I suggest you follow up with a doctor who is familiar with lymphedema.

Answered by Laser Vein Center (View Profile)

Your leg swelling is probably caused by another problem (most likely lymphedema), but there are many other reasons why the swelling could be occurring. I suggest you follow up with a doctor who is familiar with lymphedema.

Published on Jul 11, 2012


Intermountain Vein Center

Published on Mar 18, 2013

There could be other veins giving you the swelling. It could just be normal water retention or anatomy. It would be a good idea to have a follow-up with the clinic that treated your vein to see if there are other veins that need to be addressed. Varicose veins usually require multiple treatments.

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Answered by Intermountain Vein Center

There could be other veins giving you the swelling. It could just be normal water retention or anatomy. It would be a good idea to have a follow-up with the clinic that treated your vein to see if there are other veins that need to be addressed. Varicose veins usually require multiple treatments.

Published on Jul 11, 2012


Lubbock Vein Specialists

Published on Mar 18, 2013

Venous disease is a life-long problem that needs to be dealt with on an ongoing basis. Patients need to continue to wear compression hose, walk, and exercise as prevention. You may still have some venous disease, or have developed additional problems with your veins. You should return to your phlebologist for a re-evaluation.

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Answered by Lubbock Vein Specialists

Venous disease is a life-long problem that needs to be dealt with on an ongoing basis. Patients need to continue to wear compression hose, walk, and exercise as prevention. You may still have some venous disease, or have developed additional problems with your veins. You should return to your phlebologist for a re-evaluation.

Published on Jul 11, 2012


I'd recommend you contact your treating physician and discuss these issues in person.


Answered by Advanced Vein & Laser Centre, Ltd. (View Profile)

I'd recommend you contact your treating physician and discuss these issues in person.


Published on Jul 11, 2012


Bella MD Laser Vein and Aesthetic Center

Published on Mar 18, 2013

There could be multiple reasons for your leg swelling, but I would recommend an evaluation by an experienced vascular clinic.

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Answered by Bella MD Laser Vein and Aesthetic Center

There could be multiple reasons for your leg swelling, but I would recommend an evaluation by an experienced vascular clinic.

Published on Jul 11, 2012


Cosmetic Vein Centers of Texas

Published on Mar 18, 2013

It is possible that another valve is leaking, or the original ablation has opened up.

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Answered by Cosmetic Vein Centers of Texas

It is possible that another valve is leaking, or the original ablation has opened up.

Published on Jul 11, 2012


Miller Vein

Published on Mar 18, 2013

You may have residual or recurrent venous insufficiency. I would recommend that you get an ultrasound of your veins.

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Answered by Miller Vein

You may have residual or recurrent venous insufficiency. I would recommend that you get an ultrasound of your veins.

Published on Jul 11, 2012


Heart and Vein Center

Published on Mar 18, 2013

There are many potential reasons for why are still experiencing swelling more than two years after EVLA: you could have reflux on your deep veins, relfux on the small saphenous veins, insufficient perforator veins, etc. Other reasons could involve your lifestyle. Do you exercise? Are you overweight? Is your blood pressure well controlled? Are you abusing salt? How are your thyroid and heart functioning? You should have a second opinion with a board-certified vein specialist that understands issues (heart, blood pressure, etc.) other than just veins.

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Answered by Heart and Vein Center

There are many potential reasons for why are still experiencing swelling more than two years after EVLA: you could have reflux on your deep veins, relfux on the small saphenous veins, insufficient perforator veins, etc. Other reasons could involve your lifestyle. Do you exercise? Are you overweight? Is your blood pressure well controlled? Are you abusing salt? How are your thyroid and heart functioning? You should have a second opinion with a board-certified vein specialist that understands issues (heart, blood pressure, etc.) other than just veins.

Published on Jul 11, 2012


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