Dent in leg after spider vein treatment. Any suggestions on how to correct this issue?

Question

I had one spider vein treatment done on my left leg. After this treatment I now have a significant dent in my leg. You can see it when wearing light colored pants. And is very noticeable when touching leg. My doctor has offered to use filler to temporarily fix this issue. Not what I wanted to hear. Has anyone encountered this problem with such a simple procedure? Any suggestions on how to correct this issue?

Hratch Karamanoukian, MD, FACS · Answer

I must say that I have been performing vein procedures exclusively for 10 years and I have never seen this complication. That does not mean that it does not exist or it has not happened. I am sure you signed informed consent that lists the side effects and complications associated with the treatment of spider veins, reticular veins and varicose veins. I also suggest that you seek an expert who specializes in venous disease and has an interest in seeing you in follow up. The appropriate thing to do is to get a consultation from someone who has added certification from the American Board of Venous and Lymphatic Medicine. After taking an appropriate history, he/she will examine your legs, map the veins, and consider doing a venous Duplex scan where veins are measured, reflux is assessed (at saphenofemoral junction, at saphenopopliteal junction, along perforator veins) and thereafter give you a treatment plan. Even without insurance, it will be more financially affordable for you if you get appropriately treated so that you have less likelihood of recurrence where you have to spend more money to get retreated or to get additional treatments. A Board Certified vein specialist will also likely offer you MORE treatment options than someone who gives you a 'good price' but who dabbles with venous disease once in a while, while practicing colorectal or general surgery or rheumatology ... A vein specialist will likely have more than 1 way to treat venous insufficiency - VNUS Closure, EVLT, ClariVein, Varithena and more than one way to treat varicose veins - microphlebectomy, traditional sclerotherapy, foam sclerotherapy, ultrasound guided sclerotherapy ... I am sure there are a lot of Board Certified vein specialists in San Anselmo and you can start by going to the physician locator on the American College of Phlebology website. Varithena has just been approved by the FDA and is only 80% successful in treating saphenofemoral venous reflux. EVLT and VNUS Closure have better than 95% success rates at 3 days, 3 months and 5 years follow up. Other IMPORTANT considerations are whether the vein specialist works in an Accredited Vascular Lab which holds quality standards that are set by national accreditation organizations. For instance, our lab is Accredited by the American College of Radiology (ACR). One final IMPORTANT consideration is whether the physician who interprets the venous studies is CREDENTIALED by a national body to INTERPRET the venous diagnostic tests. For instance, I am a Registered Physician Vascular Interpreter (RPVI). I also holds credentials from the American Registry of Diagnostic Medical Sonographers (ARDMS) as a Registered Vascular Technician (RVT) and have credentials to do the diagnostic tests myself. I also employ 3 other RVTs in our Vascular Laboratory.As of this update (March 23, 2015), VariSeal has been cleared by the FDA to treat venous insufficiency but is not yet available for clinical use in the USA.

John Landi, MD · Answer

The complication that you describe following sclerotherapy is most unusual and I have never seen this nor do I know how to explain it.  A picture would help.  I have several questions -- what solution was used, where is the "dent", was sclerotherapy the only thing done, how long has it been since the treatment?

Dent in leg after spider vein treatment. Any suggestions on how to correct this issue?

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Dent in leg after spider vein treatment. Any suggestions on how to correct this issue?

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