I have had varicose veins removed from my leg a couple of times and need to have a couple removed now. The veins are bulging on top of my feet and look horrible. My concern is having numbness and disability as I have read that is a possibility using other vein removal treatments. I am currently being treated for Rheumatoid Arthritis, not sure if that is a factor or not. Thank you so much for your time, it is appreciated.
Is It Safe to Use Ultrasound Guided Endovenous Laser Treatment on Tops of Feet?
Doctor Answers (3)
Do not recommend EVLT or VNUS for feet
I do not recommend EVLT or VNUS on the feet - microphlebectomy or ultrasound guided sclerotherapy is the standard of care for this area.
Endovenous laser and microphlebectomy work well.
Endovenous laser could be done on these veins if it is possible to get the laser into them. The easier approach with excellent cosmetic results would be microphlebectomy(tiny 2 mm incisions and hooking out the vein with a vein hook which looks like a crochet hook). There is always a risk of a nerve injury but if it is done by someone with experience such as a vein specialist, this problem should be very minimum.
Variocse Veins on the Feet
This question could only be answered accurately if you first undergo a special ultrasound, called a venous reflux ultrasound, to see the underlying source or cause of he surface varicose veins. Varicose veins are almost universally the result of a deeper underlying vein being faulty in the leg or ankle. The valves of the vein that control blood flow begin to fail, leading to pressure buildup that leads to the surface varicose veins. The goal of treatment is to remove the underlying causative vein first. If a larger perforator vein or a saphenous vein is incompetent, then endovenous laser may be effective treatment. If after treating the underlying source vein(s), you still have some problematic veins in the feet, then usually micro-phlebectomy would be the next step. There is always going to be some risk of nerve damage or numbness with surgical removal of the veins, less so with endovenous laser treatment. We see alot of patients who have foot or ankle varicose veins, and they are usually the result of an incompetent perforator vein or saphenous vein in the leg.
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