I'm 30 years old and went in for ultrasound. Apparently, I have about 6 veins in each leg that need to be lasered. They said both GSVs and SSVs, along with some tributaries and perforators. After the lasers, injections will be done. Is this too much?
This is reasonable depending on the vein mapping. If you are concerned, you may want to get a second opinion.
Published on Jul 11, 2012
Not necessarily. The tendency to have varices and venous reflux is often genetic, and some people have multiple veins affected.
Published on Jul 11, 2012
It is not too much, except for the laser part. It is not necessarily how many times you laser someone, it is that some insurance companies do not pay for EVLT on tributaries and perforators. Depending on the insurance provider, you could be a candidate for 4 lasers (both GSV and SSV). Everything else could be treated with ultrasound injections, followed up by surface sclerotherapy.
Published on Jul 11, 2012
If there are really six superficial veins requiring ablation by virtue of proven reflux on duplex ultrasound, then the proposed treatment would be appropriate, as well as safe. However, after 25 years as a vein specialist,
I have NEVER seen a patient needing ablation of six veins. In fact, I have only had a handful that needed all four saphenous veins ablated. I suggest you seek a second opinion from a qualified vein specialist before
embarking on such an ambitious and extensive course of treatment to ensure the diagnosis and proposed treatment is accurate.
Published on Jul 11, 2012
You need to find another vein specialist, one whom you can trust to provide the care you need.
Published on Jul 11, 2012
Too many to treat with one or two appointments, but not too many if you have 4-6 appointments. That is typical of many clinics. It is much safer to divide the appointments, especially when the GSV's are treated. Usually, each GSV is treated individually. Many times laser treatments of perforators can be combined, but many times insurance will dictate the sequence. If the clinic deviates from the treatment plan, they may not get paid for the treatment they are giving.
Published on Jul 11, 2012
I would highly recommend you seek a second opinion from an experienced Board Certified Surgeon/Vascular surgeon who specializes in treating superficial venous disease if you are questioning this plan. It is rare to need all saphenous veins treated. I would typically address the GSVs first and then observe the SSVs before proceeding with further treatments. Perforator veins can be treated during the treatment of the GSVs reducing the number of invasive procedures you need. Many times the perforators and / or tributaries will shrink or close after the initial laser ablation. Second opinions are always wise.
Published on Jul 11, 2012
An ultrasound will show which veins have reflux. Although multiple veins may show reflux, not all refluxing veins need to be treated and certainly not all at once. The GSV and SSV are the most common refluxing veins and these are treated first. It is recommended that at least 6 weeks be allowed before treating any other refluxing veins, and only if these veins are contributing to a problem. The presence of reflux alone without symptoms is not an indication to treat it.
Published on Jul 11, 2012
We suggest getting a second opinion.
Published on Jul 11, 2012
It sounds a bit too many?veins to be treated with laser?. For the most part EVLT is used for truncal veins (GSV and SSV) occasionally for very large tributaries and very seldom for calf perforators. Ask for second opinion.
Published on Jul 11, 2012
While that is a lot it may all have been necessary.
Published on Jul 11, 2012
Sounds suspicious. Get a second opinion.
Published on Jul 11, 2012
Not really. If you have very advanced disease, they can combine some of those ablations in one procedure.
Published on Jul 11, 2012