By Dr. Cohen
You should always ask your doctor about the risks of treatment for any medical condition, and veins are no different. The good news is that the modern treatments for vein problems are extraordinarily safe. But nothing is completely risk-free, so let’s discuss it.
What most of my patients are most concerned with is getting a blood clot. Clots in superficial veins can occur, typically in the varicose veins attached to the vein getting treated. After any vein treatment, the flow through the attached varicose veins becomes sluggish. This can occasionally result in superficial phlebitis, the tender hardening of varicose veins, generally with some redness. I usually treat this with no more than anti-inflammatory medications (e.g. Ibuprofen), compression stockings, and lots of walking. The pain and redness usually resolves in a week or so, and the hardness over a month or so. This is usually no more than a nuisance.
More serious would be blood clot in a deep vein after an ablation, typically occurring where the saphenous vein joins the femoral or popliteal vein. The good news is that this is rare. The only ones I’ve ever seen in all my practice are small clots after ablation, which I can see on a follow-up ultrasound (we call these “EHIT’s”) and cause no symptoms whatsoever. Sometimes I treat this with some oral blood thinners, and I’ve always seen them go away in a week or so. I’ve never seen a large blood clot (or DVT) occlude a deep vein after any treatment. If this were to occur, most likely you’d see swelling. That would be a serious problem and require more aggressive treatment. You might want to read my blog, “What About Blood Clots?” for more information on this topic.
Very rarely the skin might be injured by the laser heat, resulting in an open sore. I’ve never seen this, but it should heal by itself.
Occasionally an area of skin numbness can develop due to irritation of a skin nerve from an ablation or a phlebectomy. While this is disconcerting, it isn’t dangerous at all, and usually resolves itself over 6-12 months.
Sometimes, skin darkening called hyperpigmentation can occur over veins after sclerotherapy. This is not at all risky and almost always resolves after a few months. Sometimes this is due to a little blood trapped in a vein, which can be quickly and easily drained by your doctor.
Allergic reactions to medications, like sclerotherapy drugs, can occur but are quite unusual. As with any allergy, these are usually mild, but can be serious. Always tell your doctor if you have any history of drug allergy.
Vein doctors often use a mixture of sclerosant medication and gas (usually air or carbon dioxide) for sclerotherapy, because foam is often more effective than liquid only. However there are some risks to foam, including visual or neurological disturbances. Patients with some forms of migraine are more prone to this. I use carbon dioxide foam and have never seen such reactions. But you should definitely discuss this with your doctor if foam is to be used.
Bleeding from skin puncture sites after procedures is also quite unusual and usually not serious. This almost always can be treated at home by applying pressure over the site of bleeding and lying down (with the leg higher than your chest). Certainly you should call your doctor if this occurs. And if the bleeding is severe, it would be wise to go to a local ER.
Infection? Infections almost never happen with vein treatments today. Because we don’t need to make incisions, put in stitches, or leave any foreign material in the skin, there just isn’t much that can get infected. If some cellulitis occurs an antibiotic should take care of it.
So this has been a lot of information about complications that are all pretty rare. But you should always know the risks of medical treatment. And you should always feel free to discuss questions or concerns with your doctor before proceeding with treatments.
If you have vein problems and would like to talk more about treatments, you can arrange for a quick and easy consultation with a vein expert right now by calling 201-265-5300.
About us: There are 20 million Americans with vein problems that can seriously affect the quality of their lives. And as we age, they just get worse. As one of the few New Jersey medical practices committed exclusively to vein care, Advanced Vascular Vein Care is uniquely capable of alleviating those problems, whether they are medical or cosmetic. All treatments are non-surgical, usually covered by insurance, and delivered in an office setting. And we do it as it should be done – with compassion, excellence, affordability, convenience, and the personal touch. Call 201-265-5300 or visit AdvancedVascular.com for a quick and easy consultation.