It has been suggested by a vascular surgeon that I have CVI or venous reflux. She performed sclerotherapy yesterday on my ankle after a spider vein burst. She suggested that I may be a candidate for VNUS, but my weight is a concern (I am 375 at 5'8").
Your weight increases your risk of complications related to the procedure, such as blood clots. Although losing weight will help the vein disease from progressing as quickly, unfortunately the problem will not resolve with weight loss. Once the vein valves are damaged and you have reflux, the damage is permanent unless you undergo some form of treatment.
Published on Jul 11, 2012
Excessive weight is an exacerbating factor for venous insufficiency. The
main cause, however, is heredity and despite weight loss of a hundred pounds
or more, most valve leakiness will persist afterwards, albeit the pressure
created by the extra abdominal weight might be much lower. This is another
point worth reviewing. Central, abdominal type of obesity (beer belly types
and others who carry most of their excess weight in their abdomen, is more
of a factor than the excess weight carried in the hips buttock and thighs.
Realistically, if you have had an episode of hemorrhage already, and have
correctable severe superficial venous insufficiency I would be more inclined
to perform and ablation earlier to prevent future bleeding episodes which
are likely to occur over the next few years as you endeavor to lose the 100#
or more you have been advised. Weight loss of 100# or more is like climbing
a mountain, and if your legs are heavy, swollen and achy. Exercise may prove
difficult due to pain and fatigue in the legs. So, my approach to the very
overweight or obese patient with severe symptoms of venous insufficiency and
documented severe disease is to proceed with earlier endovenous ablation,
which in turn will improve the patient's ability to exercise and lose
weight.
Published on Jul 11, 2012
Weight loss will not likely eliminate the need for treatment. However there is a direct correlation between BMI (degree of obesity) and severity of venous disease and an inverse correlation to quality of life.
Published on Jul 11, 2012
Weight loss can eliminate the symptoms of venous insufficiency but it won't correct it. Also, increased weight increases the venous pressure, which could potentially make the results of your VNUS procedure less successful. Weight loss would be beneficial. Otherwise, continuing to wear compression hose even after the procedure would help.
Published on Jul 11, 2012
While weight loss is beneficial for many reasons including reducing the abdominal pressure compressing the pelvic veins that drain the legs, weight loss is unlikely to solve incompetence of the saphenous veins. A careful venous color duplex ultrasound exam and clinical exam are necessary to sort out the causes of the high venous pressures resulting in the vein rupture.
Published on Jul 11, 2012
The weight would be a concern as well - losing weight may improve the reflux but, more importantly, what is the indication (or the need) for the vnus procedures? Are there symptoms present beyond the burst varicose vein you had (which sounds like it was treated)?
Published on Jul 11, 2012
First of all, you either are or are not a candidate for VNUS or laser ablation. A simple ultrasound exam would quickly reveal the answer. If you are a candidate, obesity is not an absolute contraindication. It is more important to reduce your risk of blood clots (thrombosis) by vein ablation than to postpone treatment if indicated. Finally, no amount of weight loss can eliminate venous reflux.
Published on Jul 11, 2012
Weight loss will NOT eliminate the need for a closure procedure is you have reflux. Although being overweight may make the procedure technically more difficult, it is not a contraindication to doing the procedure. I have performed this procedure on multiple heavy people including several in the 350- to 400-pound range. I would recommend that you have the closure done by someone with experience.
Published on Jul 11, 2012