What are the signs of hematoma after ambulatory phlebectomy and EVLT? Also, what would cause a burning sensation during an ultrasound recheck?

I experienced severe bruising and intense pain 8 days after ambulatory phlebectomy and EVLT. I could not even touch the area from my right groin all the way down to my knee. I followed all of the doctor's orders given post-op. Upon a recheck yesterday, no infection was found, but during the ultrasound the pain upon the docs pressing the area was excruciating and I felt a burning sensation go all the way up leg. What's going on? Could I have a hematoma?

Answers from doctors (5)


Vanish Vein and Laser Center

Published on Feb 10, 2020

One of the most common patient complaints post EVLT or other closure procedures is pain along the treated saphenous vein from the groin to the knee. This typically is worse about 5 to 7 days post-treatment because during this time the tumescent anesthesia resolves and the vein is in the process of contracting so the discomfort increases. Moist heat to the area and ibuprofen will help. Try this for the next week and, if no improvement, then follow up again with your treating physician.

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Answered by Vanish Vein and Laser Center

One of the most common patient complaints post EVLT or other closure procedures is pain along the treated saphenous vein from the groin to the knee. This typically is worse about 5 to 7 days post-treatment because during this time the tumescent anesthesia resolves and the vein is in the process of contracting so the discomfort increases. Moist heat to the area and ibuprofen will help. Try this for the next week and, if no improvement, then follow up again with your treating physician.

Published on Jul 11, 2012


Advanced Vein Center

Published on Sep 25, 2015

I have done thousands of these procedures and the only thing that comes to mind is a spontaneous clotting of a branch vein from the vein that was treated, and this can hurt but is not a problem and probably a "bonus" because it was a vein that might have had to be treated later. Pressure with the ultrasound probe would make it more painful.

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Answered by Advanced Vein Center

I have done thousands of these procedures and the only thing that comes to mind is a spontaneous clotting of a branch vein from the vein that was treated, and this can hurt but is not a problem and probably a "bonus" because it was a vein that might have had to be treated later. Pressure with the ultrasound probe would make it more painful.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Sep 25, 2015

Without examining you, I would say that you most likely have deeper swelling and inflammation resolving (typically 10 -14 days) when nerves become sensitive. Some slight increase in discomfort at this stage isn't uncommon. However, if larger nerves are not adequately protected (local anesthesia during the procedure), this can cause more pain. You unlikely have a hematoma. I would recommend local low heat as often as possible, take Advil every 8 hours with food, and gently massage the areas with arnica or Dermaka cream. It will be tender to begin with but will improve and desensitize the nerves, and you can gradually apply more pressure as inflammation resolves. Wearing compression hose can also increase comfort when moving.

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Answered by Vein Specialties of St. Louis

Without examining you, I would say that you most likely have deeper swelling and inflammation resolving (typically 10 -14 days) when nerves become sensitive. Some slight increase in discomfort at this stage isn't uncommon. However, if larger nerves are not adequately protected (local anesthesia during the procedure), this can cause more pain. You unlikely have a hematoma. I would recommend local low heat as often as possible, take Advil every 8 hours with food, and gently massage the areas with arnica or Dermaka cream. It will be tender to begin with but will improve and desensitize the nerves, and you can gradually apply more pressure as inflammation resolves. Wearing compression hose can also increase comfort when moving.

Published on Jul 11, 2012


The Sheen Vein Institute

Published on Sep 25, 2015

The discomfort you are feeling can be due to a few things. The first thing is that you have a lot of inflammation in the treated vein. This inflammation can irritate the nerve endings running along the vein, resulting in the burning and tingling. The second reason is that since the leg started hurting days later, you probably have one or both of the following: 1. Trapped blood that is pocketed in the treated vein. This blood only irritates an already inflamed vein to make it hurt even more. 2. You could have branches trying to feed into your now closed vein. The result is pressure spots that can cause either trapped blood and resultant pain, or just intense pressure pain. Your docs should just need to go in and treat those spots and/or trapped blood. The pain goes away rather quickly. If your docs do not know how to do this, then you unfortunately went to the wrong vein docs. Skilled vein docs know how to fix this and do so every day.

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Answered by The Sheen Vein Institute

The discomfort you are feeling can be due to a few things. The first thing is that you have a lot of inflammation in the treated vein. This inflammation can irritate the nerve endings running along the vein, resulting in the burning and tingling. The second reason is that since the leg started hurting days later, you probably have one or both of the following: 1. Trapped blood that is pocketed in the treated vein. This blood only irritates an already inflamed vein to make it hurt even more. 2. You could have branches trying to feed into your now closed vein. The result is pressure spots that can cause either trapped blood and resultant pain, or just intense pressure pain. Your docs should just need to go in and treat those spots and/or trapped blood. The pain goes away rather quickly. If your docs do not know how to do this, then you unfortunately went to the wrong vein docs. Skilled vein docs know how to fix this and do so every day.

Published on Jul 11, 2012


Destin Vein Center

Published on Sep 25, 2015

Yes, it does sound like a painful hematoma.

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Answered by Destin Vein Center

Yes, it does sound like a painful hematoma.

Published on Jul 11, 2012


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