Since we treat venous insufficiency or “ugly legs” patients, it is not uncommon to see that their vein health may be so complex that other issues like Deep Vein Thrombosis (DVT) might also come into play. DVT is a blood clot that happens in the deep veins of the body, mostly in the legs. If the clot reaches an organ like the lungs, it can be life-threatening.
Not surprisingly, since it can have severe consequences, doctors are hesitant to treat “ugly legs” patients with a history of DVT. To make matters worse, the Journal of Vascular Surgery in April 2016 showed that patients with a history of this condition were more five times more likely to have venous insufficiency. This tells us that while treating “ugly legs,” most doctors will inevitably find that they are working with patients that have had, or are at risk of developing, DVT – whether they like it or not.
Instead of avoiding treatment for fear of causing a blood clot in the immediate future, it’s important that we face the health risks head-on. But how exactly do we minimize the risk of more serious complications like DVT while working toward improving a patient’s overall health?
As we’ve discussed, traditional vein treatment has been more focused on providing a short-term fix than being a high-quality solution. When confronted with “ugly legs” patients, classic care usually advocates for one of the following:
- Leave it alone
- Long-term conservative management (e.g. compression techniques)
In other words, ablations – which have been proven to be highly effective – are still an afterthought for most health care providers. An ablation is a minimally invasive treatment that uses image-guided laser technology to “burn” the varicose veins. The burn causes scar tissue to develop which closes the vein. When you close out the vein, blood can no longer pool in the legs causing swelling, ulcers and – in some cases – the inability to move. More than just an alternative, and given the success seen with patients, ablations have become the proper standard form of care since they were first approved by the FDA over ten years ago.
We also recommend using ablations at the first sign of deteriorating vein health (e.g. varicose veins) all the way through worsening concerns like “ugly legs.” In fact, in a 2008 study, physicians observed that when more superficial concerns like varicose veins were treated using ablations, deeper issues like venous insufficiency improved or were resolved completely.
How do you know if ablation is right for you? If you’ve had a history of DVT in the past, it’s important to note that no matter how you chose to proceed, you will still be at risk for future blood clots. However, if blood is currently free-flowing, you can proceed to ablation with little caution. For added safety, your doctor may include medical prevention therapy in your ablation procedure.
If you have more severe “ugly legs” where reflux, or a back-up of blood, has been diagnosed, you should still try ablation but that will likely not be enough. In this case, you will most likely need to add long-term compression stockings to your self-care routine. For an even smaller group of sufferers, they might find that combining ablations and compression techniques will improve their symptoms, but they may never go away completely.
Regardless of how advanced one’s venous insufficiency might be (Stages of Venous Insufficiency), we believe that ablations are a proven, best-in-class treatment that should be considered for all patients. With necessary precautions taken, even patients with a history of DVT can see improvement if not a total relief of their vein issues.
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