It's been nearly 2 months since my doctor performed total ablation of saphenous vein. Leg stings. What is wrong?

Question

severe pain along the inner leg and thigh 2 months after ablation what's wrong?

Aaron Shiloh, MD · Answer

Sorry to hear about your suffering.  Studies have shown that RF ablation has a quicker recovery than EVLT but regardless 2 months is a while.  Numbness and tingling can persist for a while due to ablation of small superficial nerves.  I have seen however multiple cases of refluxing tributaries (small veins that arise from the GSV) that remain open and cause chronic pain despite the GSV ablation.  Maybe you should consider seeing your doctor and asking for an ultrasound to specifically evaluate that problem.
Good luck

Michael M. Omidi, MD, FACS · Answer

Thank you for the question! In all likelihood, the stinging sensation is a temporary side of ablation. This procedure has a potential to cause minor nerve disruption which would explain your discomfort.  I would recommend giving it time and notifying your surgeon if your symptoms don't resolve. An in-person exam would be required to determine the best way to manage your post-op pain. Best of luck!

Ivan Brooks, MD · Answer

The best treatment is time. Tingling and occasional discomfort can occur after evlt. Sometimes for periods up to 6months. But generally, this improves in the first 2 months. Use warm compress and anti inflammatory agents will help.

Michael Nguyen, MD · Answer

Most patients after radiofrequency ablation (RFA) report improvement in their symptoms within one to two weeks following the procedure. However, it can take longer than a month or two to see full results for your treatments. Follow up with your physician after the procedure for the sequence of ultrasound scans to mainly evaluate for lower extremity deep veins patency, superficial thrombophlebitis, and closure of the superficial vein that was treated with RFA. Your physician can help you with recommendations after the procedure to best manage your care and any discomfort once your ultrasound and follow up is done.
All the best,

John Landi, MD · Answer

Discomfort for 2 months post saphenous vein closure is not common but it does occur.  I have seen this most common in thin patients whose saphenous vein is close to the skin.  The stinging is due to  saphenous nerve irritation which is close to the treated saphenous vein.  There is also a component of discomfort from the treated vein contracting and causing irritation along it course in the leg.  The best treatments for this are time, wet heat to the stinging areas and an oral anti inflammatory such as ibuprofen or naprosyn. Occasionally evacuating any clotted areas may also help.

Hratch Karamanoukian, MD, FACS · Answer

If you didn't feel burning during the procedure, this sensation is most likely to be temporary and it will go away.All of my patients take Swell-x pt  after the ablation procedure and this reduces tissue inflammation in the saphenous sheath which houses the saphenous nerve. Irritation of the nerve is what would cause persistent pain and injury to the nerve would cause an "explosive feeling" around the knee. I recommend that you also use topical heat. Dr H Karamanoukian

It's been nearly 2 months since my doctor performed total ablation of saphenous vein. Leg stings. What is wrong?

Answers (6)

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