Is GSV reflux 3.5 second considered to be serious? I am very symptomatic with heavy and achy legs. Elevation and walking helps some. Will I benefit from the vein closure procedure? What are the benefits vs risks? How should I weigh this?
With your symptoms and reflux, laser ablation of the affected saphenous vein would be appropriate. You would have improved quality of life without the symptoms and a reduced risk of clotting in the superficial veins. In the hands of an experienced board-certified, vascular-trained surgeon there is minimal risk. They are office-based procedures under local anesthetic and have little downtime.
Published on Jul 11, 2012
No, it is not serious! Treatment should be based on symptoms, not ultrasound findings.
Published on Jul 11, 2012
The risk of serious complications, like ulcers or blood clots, is real but it is small. However, the burden of symptoms has significant impact on your quality of life. Most people are surprised how much better they feel and how much more energy they have after the treatment.
Published on Jul 11, 2012
Over .5 seconds is considered abnormal. In our lab, we like to say over 1 second, since sometimes between 0.5 and 1 is physiological and not that significant. Over 3 seconds, most people have some symptoms. Having strong calf muscles and a strong calf muscle pump can sometimes still overcome this. You talk about elevation and walking helping. I would consider leg elevation and sleeping with the legs elevated, compression hose 20-30 mmHg from the minute you wake up until you lie down to sleep, calf-strengthening exercises, anti-inflammatory as needed and daflon 500 or vasculera as needed. If these conservative measures do not help after a few months, I would recommend considering endothermal ablation of the leg. There are risks and benefits with every procedure. If you are having a lot of symptoms not controlled by conservative therapies, then a procedure could be worth the risks. The risks are things like blood clots, nerve injuries, infection, the laser could break, the laser could burn you or other unforeseen complications.
Published on Jul 11, 2012
Normal is below half a second. So, the answer to your questions is yes.
Published on Jul 11, 2012
The 3.5 seconds just means that your GSV is refluxing quite well. Would a venous closure procedure on your GSV fix your vein problems? It will help, but it will not address all of your vein issues. Closing your GSV is only the beginning. In order to really completely eliminate your symptoms, you really need to address not only your GSV, but also any and all refluxing tributaries all the way out to the skin level. So yes, even the spider veins and reticular veins.
Unfortunately, many self-proclaimed vein docs feel that it is only necessary to address the GSV. What they lose sight of is the fact that what makes your GSV reflux is exactly the same thing that makes your refluxing tributaries, reticular veins, and spider veins abnormal. These vessels are only in a different part of your vein structure. They all have an impact on your venous circulation, which is why you are so symptomatic.
So, hypothetically, if you say that you have 50 yards of refluxing veins in each leg, fixing the 2 ft of GSV is really not going to fix your circulation and completely eliminate your symptoms. The doc you find needs to fix your entire leg, from the GSV all the way out to the spider veins. If you have this done, which can take a few months, your legs will feel amazing. Treating only the GSV, like what many docs do, may help your symptoms, but they will not allow you to reach your full capacity without addressing the other 48-49 yards of refluxing veins. The hard part is finding a doc who knows how to do this.
Published on Jul 11, 2012
3.5 seconds of reflux is moderate to severe reflux. Reflux is significant even at 1.0 seconds, if you are having symptoms.
Published on Jul 11, 2012
Normal reflux is less than .5 seconds, so 3.5 seconds is abnormal. If you are symptomatic and have symptomatic reflux, then a closure procedure would be indicated. However, closure is usually recommended for varicose veins AND symptoms, not just aching legs without varicose veins. A trial of support hose may be indicated. See your vein surgeon for answers to risks and benefits.
Published on Jul 11, 2012