Can venous insuffency really be fixed with endovenous laser ablation? (photo)

Question

The first surgeon I saw said I had venous insufficiency in both legs. He said surgery won't fix the problem and I should just wear compressions all the time. He said I might need the veins he would be treating later in life. Then followed it up with if u want surgery let me know. I made an apt with another surgeon. I went to that apt, I didn't see the doctor but saw his nurse. I told her what first doctor said. She said he's crazy we can fix them with ela. 2 docs 2 answers don't know what to do.

Kevin Haney, MD · Answer

Venous insufficiency is absolutely treatable with a laser ablation! There are also two other great options, radio-frequency ablation, and VenaSeal. I would recommend seeing a Vein Specialist to have an evaluation so you can decide which option works best for you. I specialize in Vein Treatment, and all three treatments have very high success rates. Based on your pictures provided, you would be a great candidate. I would recommend wearing compressions before the ablation, as some insurance require 3 months with stockings before they will cover an ablation. Best of luck!

Raffy Karamanoukian, MD, FACS · Answer

Our center employs two different systems to ablate the GSV and results are sustainable longterm. Venous insufficiency is a treatable condition. Best, Dr. Karamanoukian#Realself100 Surgeon

Susan Fox, DO, RPVI · Answer

By the looks of your legs, YES! minimally invasive vein treatments can definitely help.  First we recommend a physical exam and an ultrasound.  The ultrasound will tell where the veins are not working correctly and what needs to be fixed.  This is easily fixed with lasers and possibly removing some of the veins by doing micro-phlebectomies or foam sclerotherapy after the endovenous laser.  The endogenous laser procedures are done in the office in 15-20 minutes and the phlebectomies in around 45 to 60 minutes on average.  There is little to no down time  Usually when someone has varies the veins are too large for bypass.  Usually for cardiac bypass surgery they like veins

Marcus A. Jimenez, MD, FACS · Answer

With the appearance on your photos, I don't think there is any question that your veins could be greatly improved with minimally invasive procedures.  The key to getting them treated well is finding a surgeon who is highly experienced in these type of procedures.  Many physicians treat veins these days, a much smaller percentage do it well.  If a physician hasn't performed ultrasound on you, you haven't been to the right physician.  But I do think this would be an easy fix in the right hands.

Shaun Patel, MD · Answer

An  ablation will most definitely fix the venous insufficiency.  An ablation will not rid of the varicose veins and spider veins that are seen on your legs; follow-up procedure with sclerotherapy will rid of them. Once the bad veins are closed off the blood will be diverted into the good veins and taken back to the heart. Furthermore, no doctor will use a diseased vein if you were to need a bypass. Compression stockings will help to minimize leg swelling, pain, ulcer formation but closing off the diseased veins is essential.

Craig Schwartz, DO · Answer

Yes, venous insufficiency can absolutely be fixed with laser ablation. You were given some very bad information from the 1st doctor. There is no reason you should have to wear stockings for the rest of your life. More importantly, he was also wrong about needing those veins later in life. There is no cardiac surgeon on the planet who would use an abnormal, diseased vein as a bypass graft for cardiac surgery. You should be seen by an experienced vein specialist who can help you.

John Landi, MD · Answer

Your first surgical opinion is incorrect.  Venous insufficiency has many causes and, when caused by superficial venous reflux, it can be cured by a closure or ablation procedure done in the office under local anesthesia.  You should not need to wear life long compression hose if the problem is treated.  See a vein specialist.

Hratch Karamanoukian, MD, FACS · Answer

Older surgeons, vascular and general, seem to think that you would need these veins for bypass surgery.As a former cardiac surgeon and practicing vein specialist, I would tell you that if I needed coronary bypass surgery, I would ask for the surgeon to harvest mammary arteries or radial arteries for my bypass grafts, NOT diseased and varicose veins.Chances are that you would be stented for coronary artery disease than needing bypass surgery.Read my ebook about venous insufficiency. It is free access. See link below.

Michael Nguyen, MD · Answer

Without treatment of venous insufficiency, those with the disease may experience progressive symptoms such as leg swelling, skin damage and/or ulcers that can debilitate and impact a great deal the quality of life; however, that outcome is preventable with proper treatment. Nowadays, treatments for venous insufficiency are minimally invasive, surgery is not required anymore like years ago. According to the type of treatment a patient may resume normal activities more quickly. Consider a vein specialist who you can trust that is able to recommend the best treatment for you depending first on ultrasound results and then also taking in consideration your specific goals. Your specialist may recommend a regular walking regimen and suggest you to refrain from activities like heavy lifting or prolong standing for a few weeks following the treatment as well as the use of medical compression stocking depending on the vein treatment that was used. There are vein treatments like for example Venaseal (innovative treatment) where the use of compression stocking is not necessary after treatment. There is radio frequency option and endovenous laser option where both use thermal energy and recovery time can be faster with radio frequency. There is also ultrasound guided sclerotherapy, often combined with one of the previous listed methods to treat certain areas where heat cannot be used do to proximity to the nerve preventing this way thermal injury to the nerve. Consider discussing all options available with your vein specialist.
All the best,

Ramtin Massoudi, MD - Account Suspended · Answer

Hi Dear Sammy
This is a question that I always hear. This is very important question.
Venous disease it is a chronic disease. Someone who has bad veins might still get new bad veins all her life. What it means to you. Lets say you have 2 bad veins today and you get treated with Laser/RF and sclerotherapy and with ultrasound can confirm closure of these veins. But still you might get bad veins in the future in different areas.
EVLT and RFA success rate is more than 94%, sclerotherapy success rate is more than 60-80%.
I think you need to read and understand your condition and a good doctor will try to help you decide the best option for you. 
Thank you
Ramtin Massoudi, MD

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