What is the best treatment for recurring varicose vein? (Photos)

I am 27 years old and I have had 2 Phlebectomys the first was done in November 2014 and the second was done in May 2015. My vein is getting to the point it's unbearable to stand at times again (at least once a day) and pops out so much so I'm wanting to get another treatment as soon as possible. My question is if this treatment is the best available or perhaps I should see another doctor. I'm curious about VenaSeal since phlebectomys have failed me twice so close together.

Doctor Answers 9

Varicose veins treatments

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There are various options; Venaseal closure system is innovative treatment option that uses an adhesive to seal the vein and does not require the use of compression stockings after the procedure. Other treatment options are the thermal energy that uses heat to treat the vein, but does require compression stockings after the procedure. Another treatment option is guided sclerotherapy that uses a chemical liquid or foam to treat the vein. My recommendation is that first you go to see a vein specialist who you can trust and help you make an informed healthcare decision. Depending on your Venous Doppler insufficiency evaluation results, the specialist can help you decide what treatment or combination of treatments is best for you. 

All the best, 

Foam Sclerotherapy using ultrasound guidance

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Venaseal may indeed be a solution for you but there is no substitute for seeing a vein specialist who does a focused ultrasound (make sure it is done in the standing position so they can see the effect of gravity and get all the details!). There are a number of different techniques for treating the vein but you want to make sure your doctor gets to the root of the varicose veins, not just the varicose veins themselves. If you don't treat the root (with laser, EVLT, RF, foam sclerotherapy, Venaseal, Varithena, I could go on and on), the veins will return. A competent vein specialist will treat the ROOT of your problem, not just the veins at the surface.

Albert Malvehy, MD
Miami Beach Physician
5.0 out of 5 stars 8 reviews

I recommend a complete venous reflux evaluation with colorflow doppler ultrasound of that leg

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There is likely a feeding vein that is causing the varicosities.  It needs to be identified and if refluxing should be closed.  Venaseal is one possible way to close the feeding vein.  EVLT and Radiofrequency ablations are also probably options or possibly sclerotherapy.  I would get a complete STANDING.venous evaluation at a dedicated vein treatment center to find out where the problems lie and help to formulate a treatment plan.

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Painful vein post phlebectomies

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I would see a vein specialist who can perform a venous insufficiency ultrasound to determine what is the cause of the recurrent varices and leg pains. Sometimes there is an underlying vein that has insufficiency that is causing the problem. This vein may not be visible and could have gone Untreated with your former phlebectomies. There are several options to close off insufficient veins. Venaseal is one option but it is expensive and not covered by insurance. Other options are covered such as endovenous laser, radio frequency ablation, clarivein, ultrasound guided foam sclerotherapy and others. Hope this helps. 

Susan Fox, DO
Hollywood Phlebologist
5.0 out of 5 stars 8 reviews

You need to see an expert who can scan you him or her self

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Unfortunately, the answer is not simple.  The real issue is getting an understanding of the venous reflux pattern and in my opinion that is best done by a doctor who is expert in venous disease.  As an interventional radiologist, I have spent my career using ultrasound, and not just a weekend course.  You should seek out someone who is interested in this disease and will scan you themselves.  This is really the only way to get to the root of the issue.

Aaron Shiloh, MD
Philadelphia Physician
5.0 out of 5 stars 6 reviews

Recurrent veins

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I recommend you see a vascular specialist since you might have underlying venous reflux that can be identified by a simple ultrasound. If there is reflux in the saphenous veins then I recommend fixing that first before proceeding with phlebectomy or sclerotherapy. 

Ramandeep Sidhu, MD
Issaquah Vascular Surgeon
5.0 out of 5 stars 8 reviews

Treatment options

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From the pictures it looks like you have soft tissue damage or scarring where the prior phlebectomy was performed. You do look like you have varicose veins around the knee area. A sign that you may have reflux disease in the larger superficial veins of the leg. I would recommend a venous ultrasound to determine the cause of your varicose veins. There are great minimally invasive treatments that should improve the look and physical well being of your venous issues. Definitely worth looking into. 

Recurrent varicose vein

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I wonder if you have had any ablation or closure procedures prior to the phlebectomies.  If there is a large truncal vein or feeder under the area of the varicose vein, then it needs to be treated before the varicose vein can be treated.  I suggest getting a second opinion with a full ultrasound to look for the source of the venous disease.

Lisa Perez, MD
Atlanta Physician

Recurrent varicose veins

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If your varicose veins recurred so quickly, I would be concerned that you might have underlying venous reflux that has not been identified.  You should see a vascular specialist and have a high quality duplex ultrasound, preferably in an Accredited lab, to be sure you receive an accurate diagnosis.  Regarding Venaseal, that is a particular treatment for venous reflux.  There are others, such as RF ablation (Closure), endovenous laser, and Clarivein.  All of these are effective in treating reflux.  The reason to have one vs. the others is usually based on factors such as physician preference and experience and insurance coverage issues. Prior to knowing what treatment is best, you need to have a correct diagnosis.

Jeffrey Gosin, MD, FACS
Atlantic City Vascular Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.