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Vascular Surgery/Recent EVLT with Phlebectomy



I am a 50 year old male with very bad varicose veins on both legs.  I am a runner and a golfer.  The legs never gave me much of a problem but they are unsightly, and I assumed that as I age they will become more painful and uncomfortable.

I live in NY and finally decided to move forward with vein surgery.  My vascular doctor recommended EVLT with phlebectomy in both legs (with twilight anesthesia).  The surgery on my right leg took place 12 days ago and the left leg is scheduled for mid March.

The procedure on my right leg took place January 4th and was an EVLT on my saphenous vein and phlebectomy on many smaller veins in my lower leg (front, back, side).  They incisions are healing pretty nicely ... still fairly bruised ... but I can see the leg will look much better although there will still be some smaller visible veins.

My issue is that my right calf remains very painful.  It almost feels like a pulled muscle on the back of the calf from top to bottom, with one particularly painful spot in the middle of the calf.  For the most part, the calf is sore but OK when walking or sitting.  But when I stand in one place for more than a minute or so the calf begins to stiffen and ache intensely.  I have had three follow up sonograms due to the pain to make sure there is not DVT or clot, and there aren't any.  Yesterday the vascular doctor said I had "a little phlebitis" and that I should take one baby aspirin per day in addition to my advil regimen.  I have been wearing a knee high compression stocking since the surgery - taking it off only at night.

My question is does this sound like a normal response to this type of surgery?  Of course, everything you read and hear from the doctors in advance of the procedure is that recovery takes place in a couple of days and you can resume all activities relatively quickly.  This is not the case with me and I want to make sure that I can expect to feel better reasonably soon.  I am not very patient when it comes to recovery and since the procedure was "elective", I am worrying that I may have done something which will cause long term difficulties.  I am also thinking about the other leg and whether I will want to do that one if these issues persist.



oh my gosh your procedure was 12 days ago? of course you are still recovering.
the procedure works by clotting off the incompetent vein, this in turn slows the rate of bloodflow in the adjacent veins, when our blood flow slows, we clot. the wraps applied after the closure help to promote absorption of the clot, but sometimes phlebitis results rather than absorption. this happens fairly frequently.
tincture of time & compression are only remedy...moist heat can make it feel better but it just takes time
yes it is an elective treatment, but untreated venous incompetence can lead to open ulcerations of the skin that are very difficult to heal, unless you wear compression hose to decrease the pressure in the veins, i personally would choose the possibility of phlebitis over certainty of venous stasis ulcers
it is entirely possible that the second closure WILL go off without a hitch and that in a couple days you wont even know it happened, but it is also possible you will have this same experience
i dont think this surgical sequelae will cause any permanent problems, i think, if your symptoms are bothersome and the veins are not working you should get them fixed, take the opportunity to eliminate the potential problems that can occur without treating the incompetence
sorry you had complications but hope you go forward with the plan
hope this helps

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Lauri Ordway


I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses 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. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.


I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and 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 the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

I am an LPN, licensed in Minnesota

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