Frequently asked questions

After closed (non-surgical) ablation and mini-phlebectomy, most patients can walk the next day and return to desk work within a few days. If you do heavy physical work, recovery may take longer. The exact time depends on the method used and the extent of the procedure.

A treated vein does not reopen once it has been closed. However, because the underlying tendency remains, new varicose veins can develop in other veins over the years. Wearing compression stockings and regular follow-up reduce this risk.

No pain is felt during the procedure because local anaesthesia is used. Afterwards, tightness and bruising may last a few days and are relieved with simple painkillers.

Spider veins are often a cosmetic problem, but whether there is a leak in a larger vein underneath should be checked with imaging. Treating spider veins without correcting an underlying leak leads to recurrence within a short time.

Leg swelling that increases toward the evening and decreases after waking up is the most common early sign of venous insufficiency. However, swelling caused by the heart, kidneys or thyroid can look similar. Examination and imaging make the distinction.

Veins that become visible under the skin are usually superficial venous dilatation. If they are accompanied by bruising, pain and heaviness at the end of the day, they should be evaluated. The first step is always to check with imaging whether there is a leak.

The situation people describe as a clot "going to the leg" is usually deep vein thrombosis: a clot forming in a deep vein of the leg. Less often, a clot that breaks away from the heart and blocks an artery of the leg is also described this way; in that case the leg suddenly becomes cold, pale and very painful. Both situations are urgent and should be evaluated without delay.

What distinguishes them is timing. Varicose swelling develops over years, increases in the evening, goes away in the morning and is usually on both sides. Swelling due to a clot starts within days, affects one leg and does not go away with rest. The definitive distinction is made by imaging.

The duration depends on the person. For a first clot caused by a temporary cause, a few months of treatment is usually enough. The duration is longer when no cause is found, when clots recur, or when a lasting risk such as cancer persists. This decision is made by the physician who follows you.

In the past, strict bed rest was recommended; today this approach has been abandoned. Once treatment has started, walking together with a compression stocking reduces swelling and pain. Very strenuous sports are avoided at the start.

There is a risk of recurrence, and it depends on the cause. The risk is lower for clots caused by a temporary reason (surgery, a cast, a long journey). The risk is high for clots that form without an obvious cause; in these patients the treatment duration and follow-up are planned differently.

Sitting still for a long time increases the risk of a clot. Swelling, tightness and pain in one leg after a journey should be taken seriously and evaluated with imaging.

The two can be confused. Pain from the vessels always starts at the same distance and goes away when you stop. Pain from the back is related to posture; it eases when you bend forward or sit down, and the distance varies. The distinction becomes clear with examination and imaging.

An opened vessel can narrow again if risk factors are not controlled. Quitting smoking and taking medicines regularly are the most important factors that determine whether the opening lasts. Regular imaging follow-up is recommended.

For a wound to heal, enough blood must reach that area. Dressings and antibiotics alone do not work when circulation is insufficient. For this reason, foot wounds that do not heal should first be evaluated for the blood vessels.

In this disease, smoking is by itself the most decisive factor. Quitting increases walking distance, prolongs the time an intervention stays open and reduces the risk of limb loss. All other treatments work less well while smoking continues.

In people with diabetes, a sore that opens on the foot is called a diabetic foot ulcer. For these wounds to heal, enough blood must reach the area. For this reason, circulation in the vessels must be evaluated first when treating the wound.

Constant coldness and numbness in the feet can indicate reduced blood flow through the arteries. Nerve involvement due to diabetes can cause similar complaints. Pulse examination and imaging are needed to tell the two apart.

Your trunk and face will become slimmer, but the lipedema tissue in the legs largely stays the same. This is one of the defining features of the disease. Losing weight is still beneficial, because excess weight adds to the complaints.

If untreated, it can progress over the years: pain increases, movement is restricted, and the lymphatic system can be affected, leading to lipolymphedema. Compression and exercise started early slow this course.

Yes, because veins dilate in heat and complaints increase. In summer, thinner, breathable knit models can be preferred. What matters is maintaining the pressure class.

Both are commonly seen together. If imaging shows a significant venous leak, that is usually treated first, because venous insufficiency increases swelling and pain and worsens the complaints of lipedema. The order is determined by the examination findings.

The most practical distinction is the feet. In lymphedema, the swelling also involves the top of the foot and the skin at the base of the toes thickens. In lipedema, the feet are spared, and the thickening ends at the ankle with a sharp border. Lipedema is painful and bruises easily; in lymphedema this is not typical.

A clear disproportion between the trunk and the legs, especially in women and when it started after puberty or pregnancy, suggests lipedema. The most typical finding is that the trunk becomes slimmer with diet while the legs stay the same. An examination is needed for a definitive distinction.

Lymphedema is a chronic disease and cannot be completely eliminated with today's methods. However, with regular treatment, swelling can be greatly reduced, its progression can be halted and infection attacks can be prevented. Treatment started in the early stage gives a clearly better result.

During the intensive treatment period, bandages are used; afterwards, a custom-fitted compression garment is used. When compression is stopped, the swelling returns, so use is usually continuous. Garments lose their elasticity, so they should be replaced every six months.

Swelling of the arm after removal of the lymph nodes in the armpit or radiotherapy to the area is the most common cause of secondary lymphedema. It can appear months or even years after surgery. A feeling of heaviness in the arm, and rings or watches feeling tight, can be the first warning signs.

Lipedema is symmetrical on both legs, the feet are spared, and pain is prominent on touch. Lymphedema is usually one-sided, involves the top of the foot, and the skin on top of the toe cannot be pinched up. This finding is called Stemmer's sign and is the most practical examination sign in the distinction.

In an area affected by lymphedema, sudden redness, a rise in heat, pain and fever suggest cellulitis, an infection of the skin and the tissue beneath it. This condition requires antibiotic treatment without losing time. Attacks should not be postponed, because each one causes new damage to the lymphatic system.

Classic massage is not suitable for lymphedema and may even cause harm. The method to use is manual lymphatic drainage; this is a special technique performed with very light pressure and in a specific sequence. It should be performed by a physiotherapist trained in this technique.