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Suggest Treatment For Venous Reflux In Legs
Question: Tests taken about 3months ago show I have venus reflux in left and right legs that is causing a felling of "pins-and-needles" in both feet at night and swelling when I sit for an hour or two with little movement (as in movie theater, concert or at the computer). These symptoms started about 3 months and I'm not bothered by them when I'm active.
The doctor (Interventional Cardiologist) wants to perform a procedure to close or block the superficial leg veins to correct the problem.
No anesthesia is to be used; instead, 20 mg of Valium will be administered. Usual recovery period is 2-3 days, I been told.
Questions: What is the procedure called and should I get a second opinion before agreeing to this? What options are open to me other than the recommended procedure? Which of these options would be best for someone my age and activity level.?
Age: 83, tennis player (average 3 X a week). Lab tests reveal that I'm in good health otherwise. And, I'm feeling find.
Thank you.
The doctor (Interventional Cardiologist) wants to perform a procedure to close or block the superficial leg veins to correct the problem.
No anesthesia is to be used; instead, 20 mg of Valium will be administered. Usual recovery period is 2-3 days, I been told.
Questions: What is the procedure called and should I get a second opinion before agreeing to this? What options are open to me other than the recommended procedure? Which of these options would be best for someone my age and activity level.?
Age: 83, tennis player (average 3 X a week). Lab tests reveal that I'm in good health otherwise. And, I'm feeling find.
Thank you.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that there are two main groups of optional treatment for reflux (insufficiency): (1) endovenous, or (2) surgical approach
Seems that your interventional cardiologist is offering you one of the endovascular treating options for venous reflux as follows:
(1) Sclerotherapy (with or without ligation) by injecting or infusing a sclerosing substance into the refluxing vessel to produce endothelial destruction and fibrosis of the treated vessel.
(2) Endovenous laser therapy (EVLT) is performed by passing a laser fiber from the knee to the groin and then delivering laser energy along the entire course of the vein leading to destruction of the vascular wall and subsequent fibrosis of the treated vessel.
(3) Radiofrequency ablation (RFA) is performed by passing a special radiofrequency catheter from the knee to the groin and then delivering programmed heating of the targeted vessel until thermal injury causes shrinkage.
Besides the above nonsurgical options (one of them is the procedure your cardiologist has offered you), other surgical techniques may be applied for your case, such as
(a) subfascial endoscopic perforator surgery (SEPS) where endoscopic techniques are used to find and ligate perforating veins.
(b) ligation with stripping of the veins
(c) simple ligation and division
(d) stab evulsion (with or without ligation), etc
Every performed technique and option (endovenous or surgical) has its own advantages and potential complications, but facing your actual clinical status (symptomatology, age, physical profile), I believe that the option offered by your cardiologist (when handled by experienced proffesional experts) offers excellent results, a very short recovery interval, and also a satisfactory safety profile.
You can discuss with a phlebologist (a physician or vascular surgeon specializing in venous diseases) to review all the available treatment options to your living area and choose another alternative (if you do not prefer the recommended one).
Hope to have been helpful to you!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that there are two main groups of optional treatment for reflux (insufficiency): (1) endovenous, or (2) surgical approach
Seems that your interventional cardiologist is offering you one of the endovascular treating options for venous reflux as follows:
(1) Sclerotherapy (with or without ligation) by injecting or infusing a sclerosing substance into the refluxing vessel to produce endothelial destruction and fibrosis of the treated vessel.
(2) Endovenous laser therapy (EVLT) is performed by passing a laser fiber from the knee to the groin and then delivering laser energy along the entire course of the vein leading to destruction of the vascular wall and subsequent fibrosis of the treated vessel.
(3) Radiofrequency ablation (RFA) is performed by passing a special radiofrequency catheter from the knee to the groin and then delivering programmed heating of the targeted vessel until thermal injury causes shrinkage.
Besides the above nonsurgical options (one of them is the procedure your cardiologist has offered you), other surgical techniques may be applied for your case, such as
(a) subfascial endoscopic perforator surgery (SEPS) where endoscopic techniques are used to find and ligate perforating veins.
(b) ligation with stripping of the veins
(c) simple ligation and division
(d) stab evulsion (with or without ligation), etc
Every performed technique and option (endovenous or surgical) has its own advantages and potential complications, but facing your actual clinical status (symptomatology, age, physical profile), I believe that the option offered by your cardiologist (when handled by experienced proffesional experts) offers excellent results, a very short recovery interval, and also a satisfactory safety profile.
You can discuss with a phlebologist (a physician or vascular surgeon specializing in venous diseases) to review all the available treatment options to your living area and choose another alternative (if you do not prefer the recommended one).
Hope to have been helpful to you!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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