I tell my patients that the bulging veins that arise from the great or small saphenous veins will reduce in size within the first few weeks after an endovenous ablation procedure. Most of the time the bulging veins do not completely go away. The bulging veins can then be treated with an ambulatory phlebectomy or sclerotherapy.

Published on Jul 11, 2012

As a Board Certified Vascular trained surgeon, I typically remove the large bulging varicose veins at the time of the saphenous vein ablation. This is done through tiny punctures with no stitches involved. In theory, 50% of varicose veins MAY shrink down after sealing the saphenous vein. This means that 50% will not. I prefer to do this at the same procedure as it reduces the chance of needing a second procedure, time off work and more cost to you. However, be patient, you are early in the healing phase. I would recommend you wear your hose.

Published on Jul 11, 2012

Hi and thank you for your question. It will continue to heal and it is important to let it heal completely before anything else. After the main source of the problem has been treated with radio-frequency ablation, the best way to help these bulging veins if they don't disappear completely is by recurring to minimally invasive and localized procedures that can shorten this process tremendously. After the healing time is finished, your concern can be treated with advanced methods like Ultrasound Guided Sclerotherapy and other times if necessary Ambulatory Phlebectomy depending on what is appropriate. Not all the cases are the same and not everyone responds to treatment in the same way or take the same time to heal. I recommend you that you follow up with your vein specialist and let him re-evaluate with ultrasound imaging in your follow ups to decide the best approach to continue with your care.

Published on Jul 11, 2012

Surface varicosities that remain after underlying saphenous vein ablation may either disappear if they regain valvular competence, or remain if they don't. If not treated at the same time as ablation, either phlebectomy surgery or sclerotherapy can finish the job. Because many people complain
of persistent surface veins after ablation, I usually treat them during the ablation procedure for expediency.

Published on Jul 11, 2012

The visible or varicose veins can resolve after an ablation but in my experience in at least 50 percent of cases they do not completely go away. Some further form of treatment, such as phlebectomy or sclerotherapy, is usually needed.

Published on Jul 11, 2012

The reduction of the varicose vein that you have seen to date is likely what you should expect. Waiting an interval following VNUS or laser ablation is considered prudent and conservative, as perhaps as many as 50 percent of patients will be satisfied with the reduction in size of the varicose vein after one VNUS treatment and seek no further treatment. In some patients, the varicose veins may almost completely disappear after a closure procedure. The other 50 percent may require a staged procedure to remove the remaining varicosities. This could be done through smaller and fewer incisions and less resulting bruising, yielding a better overall result. There are a number of opinions regarding the sequencing of closure and microphlebectomy, and there really is no absolute right or wrong answer.

Published on Jul 11, 2012

A closure procedure usually does not eradicate the varicose veins. The closure procedure procedure seals the leaking valves of the feeding veins that cause the varicose veins. The varicose veins then usually need to be treated by microphlebectomies or sclerotherapy.

Published on Jul 11, 2012

It could take a few weeks. If not resolved, there are other measures which can be taken to treat it -
and hopefully your doctor will offer them to you.

Published on Jul 11, 2012

Give it about 6 weeks. Anything that does not resolve within 6 weeks may require some additional treatment. Patients get a wide range of response to VNUS, with some having complete resolution of their veins and others only partial response and need additional treatment. The main benefit of VNUS is that it will cure the underlying problem that is causing the varicose veins to develop so that no further varicose veins develop or worsen over time. However, the vein damage that has already occurred prior to VNUS may not be completely reversed with VNUS and may lead to your needing additional "cosmetic" treatments. These additional treatments should get rid of the surface veins that do not shrink and disappear after the VNUS procedure.

Published on Jul 11, 2012

Final remodeling will be evident after 6 weeks. Sometimes sclerotherapy is needed after VNUS, and it may be useful for the remaining calf vein.

Published on Jul 11, 2012