AboutLauri Ordway Expertise I can answer your questions related to peripheral vacular disorders. This includes all arteries and veins except those inside the head and inside the heart. IE: neck (carotid), arms (carotid subclavian bypases to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wound treatments. Also, Raynauds, Buerger`s disease, Thoracic Outlet and other miscellaneous vascular disorders.
I CANNOT answer questions about your heart disease, blood pressure, brain aneurysm, although I can help with questions about the arteries that go to and from those organs.
Experience I am a nurse, I have worked for 14 years with two terrific peripheral vascular surgeons, one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage our clinic website and field questions from patients all over the world.
Question QUESTION: I had varicose veins in both my legs and had the VNUS Closure procedure done on them. It has been almost 2 years since it was done and both legs continue to swell,tingle and be painful. I wear my compression stockings faithfully.Does this mean there is posssble deep vein involvement? Is there anything alse that can be done.I am still young and don't like to be slowed down. Thank you.
ANSWER: Deb,
no, it likely does not mean deep vein problems, sometimes, when the greater saphenous vein is closed, other veins either become incompetent or they may have been incompetent before the closure but the ultrasound couldn't tell because so much blood was pooling in the gsv. this seems to happen about 5% of the time in our practice. I suggest you ask for a return visit to the surgeon who did your closure and see if there are additional problems, usually at about 6 months after closure, what you see is what you got :) so, if 2 years later you still have the same symptoms something is wrong :(
it may be that you just need to have some remaining veins "stabbed" (Sounds worse than it is) out-or you may need another closure or you may need an actual ligation of the sapheno-femoral junction at the groin. Did you EVER have relief after your closures? Lauri
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QUESTION: I never had relief after the closures. On the left leg the upper thigh was done. On the right the upper leg was done first. Then problems remained, large varicose vein remained on upper thigh and that was stabbed. Swelling and pain persisted and lower leg had vnus closure done due to a winding connecting perforator vein. No relief. I did have an old fracture to my lower right leg many years ago. This sure can be frustrating. Thank you so much. I appreciate your response.
ANSWER: well, the only way to tell what is causing the problem is a good venous ultrasound, need one that identifies all superficial, incompetent veins or neo-vessels (new veins that we grow, great plan huh?)the neo-vessels never have valves so they can have reflux (pooling blood) from an incompetent sapheno-femoral junction or a pelvic source (most common culprits) but you need to have a really good venous ultrasound technician do the test, or something may get missed- and that may be the source of the original problem, venous specialists aren't common- the group we use has 6-8 techs and our docs will only let me set up vein ultrasounds with one of them, if we get a venous ultrasound froom someone else, it is an automatic re-do....and usually, the two reports are different with Dan's finding the real source of the problem)
by the way what kind of surgeon did the closure? general? dermatologist? radiologist? vascular? was it done in surgery center under anesthesia or in md office? where are you????
Once you get the US,you should find the nearest closure specialist with the most experience as it is always harder ad sometimes impossible, after closure done in past, but, it sounds llike it never really "took" so possible can be redone or done differently.
lauri
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QUESTION: Thank you so much for your replies. I went to a general/vascular surgeon. He was the first in my area do do the closure procedure went it first was available. One surgery was done in the hospital and the others in his office. He moved his office to be able to do these there. Follow-up US did show that they were successful. Thanks again.
Answer IT IS UP TO YOUBUT IF YOU SUFFER WITH THE SAME PROBLEMS AS BEFORE CLOSURE, THE GSV CLOSURE MAY HAVE GONE WELL BUT THERE IS SOMETHING WRONG, THERE ARE 5 BRANCHES OF VEINS AT THE JUNCTION WITH THE GSV, MAYBE ONE OF THEM IS INCOMPETENT AND NEEDS WORK, I'D MAKE AN APPT W/ CLOSURE DOC, IN PAST TWO YEARS THERE ARE 2 NEW CATHETERS THAT BOTH WORK REALLY WELL AT THEIR DIFFERENT JOBS. LAURI
