The first place I went to did a very superficial ultrasound study while I was lying down, performing the Vasalva maneuver. This study showed venous insufficiency in my saphenous veins. They recommended EVLT/sclero. Insurance denied that and had me go to a different place. Much more thorough exam, which determined normal veins. I do have a lot of reticular veins and spider veins I would like to take care of. Should I see another specialist? Is it bad to do EVLT if I don't have insufficiency?
Answer: EVLT will help with true reflux EVLT should only be done in the presence of reflux. I would recommend getting another opinion since you've had conflicting results. The ultrasound evaluation should be done standing up while performing maneuvers like distal augmentation, proximal compression, valsalva and parana maneuver among others. Unfortunately, an ultrasound evaluation is in part technician dependent and sometimes reflux is missed if performed by an inexperienced technician even when it may seem thorough. If you do in fact have reflux, then EVLT is appropriate and may also help in more successful sclerotherapy of reticular and spider veins, as well as diminish likelihood of recurrence.
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Answer: EVLT will help with true reflux EVLT should only be done in the presence of reflux. I would recommend getting another opinion since you've had conflicting results. The ultrasound evaluation should be done standing up while performing maneuvers like distal augmentation, proximal compression, valsalva and parana maneuver among others. Unfortunately, an ultrasound evaluation is in part technician dependent and sometimes reflux is missed if performed by an inexperienced technician even when it may seem thorough. If you do in fact have reflux, then EVLT is appropriate and may also help in more successful sclerotherapy of reticular and spider veins, as well as diminish likelihood of recurrence.
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Answer: EVLT to treat normal veins. There would be no reason to perform an EVLT on a normal vein. Based on your description, I would have a tendency to rely more on the results of the second, more thorough exam. You certainly can have the spider veins treated properly with sclerotherapy. Unfortunately, in my experience, that would be unlikely to be covered by insurance.
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Answer: EVLT to treat normal veins. There would be no reason to perform an EVLT on a normal vein. Based on your description, I would have a tendency to rely more on the results of the second, more thorough exam. You certainly can have the spider veins treated properly with sclerotherapy. Unfortunately, in my experience, that would be unlikely to be covered by insurance.
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March 22, 2018
Answer: Save your Saphenous If you had a thorough ultrasound while standing that did not demonstrate reflux, I would seek direct treatments for you reticular and spider veins. Further, do you have leg swelling, achiness, pain, or fatigue? If you have none of these symptoms, you do not need to worry about doing an EVLT on your sapheous vein. Unfortunately, there are a few vein practices (typically large chains, think McDonalds) who train their employees to make the vein look bad even when they are not.
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March 22, 2018
Answer: Save your Saphenous If you had a thorough ultrasound while standing that did not demonstrate reflux, I would seek direct treatments for you reticular and spider veins. Further, do you have leg swelling, achiness, pain, or fatigue? If you have none of these symptoms, you do not need to worry about doing an EVLT on your sapheous vein. Unfortunately, there are a few vein practices (typically large chains, think McDonalds) who train their employees to make the vein look bad even when they are not.
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March 11, 2018
Answer: IF it aint broke don't fix it Why treat something that is not broken. I would not respect the physician who is recommending this procedure when you do not have venous insufficiency. There are risks with any procedure and if you do not have venous insufficiency then the benefits do not out weight the risks. I would not go back to a doctor who is recommending a procedure when you have no reason to be treated.
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March 11, 2018
Answer: IF it aint broke don't fix it Why treat something that is not broken. I would not respect the physician who is recommending this procedure when you do not have venous insufficiency. There are risks with any procedure and if you do not have venous insufficiency then the benefits do not out weight the risks. I would not go back to a doctor who is recommending a procedure when you have no reason to be treated.
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November 14, 2017
Answer: Repeating Venous Doppler ultrasound for venous reflux Thank you for your question. I recommend repeating Venous Doppler ultrasound for venous reflux. This time, try to be well hydrated, avoid caffeinated products prior to ultrasound imaging, exercise beforehand, be standing for reflux evaluation portion of the test, and make sure exam room and exam table are not too cold. By doing these above, you are preventing constriction of the vessels and increasing the chances of finding retrograde flow if reflux is really happening in your LE venous system. Varicose or dilated veins showing in the surface of the skin is one of many signs and symptoms of venous reflux. Also, discuss with your vein specialist the different treatment options if underlying venous insufficiency is present as well as treating your cosmetic concerns otherwise. Best ,
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November 14, 2017
Answer: Repeating Venous Doppler ultrasound for venous reflux Thank you for your question. I recommend repeating Venous Doppler ultrasound for venous reflux. This time, try to be well hydrated, avoid caffeinated products prior to ultrasound imaging, exercise beforehand, be standing for reflux evaluation portion of the test, and make sure exam room and exam table are not too cold. By doing these above, you are preventing constriction of the vessels and increasing the chances of finding retrograde flow if reflux is really happening in your LE venous system. Varicose or dilated veins showing in the surface of the skin is one of many signs and symptoms of venous reflux. Also, discuss with your vein specialist the different treatment options if underlying venous insufficiency is present as well as treating your cosmetic concerns otherwise. Best ,
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