General FAQs
If you’re considering UK Veincentre (UKVC) for your vein treatment, it’s understandable that you might have a few questions.
We’ve tried to answer some of the most frequently asked questions about our clinic, staff, policies and terminology here.
Alternatively, check out our conditions FAQs for all your questions about varicose veins, thread veins and leg ulcers, or our treatment FAQs for questions about endovenous laser ablation (EVLA), foam sclerotherapy, microsclerotherapy or thermocoagulation.
If you have any other questions, please do not hesitate to contact our clinic team, who will be happy to help.
Processes & Timescales
When is the optimal time to address my varicose veins?
Ideally, the earlier you seek treatment, the longer you will benefit from the results. However, given that the progression of varicose veins is typically gradual, there is no urgent need for immediate action.
Many patients find it advantageous to consider treatment in the autumn or winter months, as the cooler weather tends to make the recovery more comfortable. Additionally, this timing allows for ample recovery time well before the onset of the following summer, so you can show off your new legs!
Can I have treatment after laser hair removal?
We advise that patients wait at least three months after laser hair removal before having any vein treatments.
What is involved in the initial consultation process?
The first part of the consultation involves a discussion with your specialist consultant to ascertain the nature of your concerns, understand how they impact your daily life, and determine your desired treatment outcomes. Additionally, we will enquire about various aspects of your health and lifestyle, including any allergies, as these factors can influence the available treatment options.
Subsequently, a brief physical examination will be conducted by the consultant or nurse practitioner. Following this, a colour duplex ultrasound scan will be performed on both legs to identify the root cause of your varicose veins, particularly whether faulty valves are contributing to the issue.
The consultant will meticulously examine all the veins in your legs to identify any potential underlying problems contributing to your varicose veins. They will then discuss the scan results directly with you, providing a clear explanation of the identified problems and suitable treatment options. Feel free to ask any questions you may have during this discussion.
After the consultation, you will receive a comprehensive consultation report along with an exact quote for the agreed-upon treatment.
Who conducts the colour duplex ultrasound scan?
The colour duplex ultrasound scan is a crucial component of our consultation process, aiming to precisely identify the cause of your vein issues and determine the necessary treatment and its exact location.
This scan can be conducted by a consultant interventional radiologist, a vascular surgeon, or a specialised venous nurse practitioner. Ideally, the individual performing the scan should be the one responsible for administering your treatment.
While some doctors collaborate with sonographers for scanning and focus on the procedural aspects, at UKVC, we opt for a more streamlined approach. We do not adopt the practice of employing both a doctor and a sonographer, considering it inefficient and less cost-effective for the patient. Furthermore, we believe that the treating doctor should have a comprehensive understanding of the scan results to make informed judgments about the relevance of the findings. Relying solely on a written report from a third party, such as a sonographer, for treatment planning is deemed less than ideal.
At UKVC, all our consultants and some of our nurses possess advanced skills in color duplex ultrasound scanning.
Is it possible to have treatment on the same day as my consultation?
At UKVC, we encourage patients to attend an initial consultation first, in advance of any treatment. This serves the dual purpose of providing you with comprehensive information about the treatment while allowing our venous specialists to assess your condition and determine the most suitable treatment for you.
Following the consultation, you will have the opportunity to reflect on the information, conduct additional research, and make an informed decision about proceeding with the treatment.
While we value the deliberative process, we acknowledge that some patients may travel considerable distances. In such cases, we are open to exploring the possibility of organising treatment on the same day. This, however, may necessitate an online or phone consultation before your visit to the clinic.
Is there a restriction on the number of veins treated in each leg?
There is no specific limit to the ablation (destruction) of superficial veins. However, in certain cases, it might be necessary to divide the treatment over two visits instead of addressing all veins in a single session on the same day.
This precaution is due to the safety constraints on the amount of local anesthetic and/or chemical sclerosant that can be administered in one visit.
It’s exceptionally rare for EVLA to be carried out on two separate occasions; this circumstance arises only when the total length of the veins requiring laser treatment is extensive. Any such considerations will be discussed with you during the initial consultation.
Will I notice an immediate difference after the treatment?
Following the procedure, you’ll be required to wear a compression stocking for a week, hindering a direct view of your leg(s) during this period. Upon removing the stocking, you may observe a slight improvement in the appearance of the veins, but they are unlikely to have completely disappeared yet.
For varicose veins, treatment generally involves two stages: the initial step is the EVLA procedure. Subsequently, we schedule a follow-up appointment approximately six to eight weeks later. During this follow-up, we administer additional injections of foam sclerotherapy to target any remaining visible varicose veins.
Since most individuals need foam sclerotherapy in addition to EVLA, the full effect of the treatment typically becomes noticeable two or three months later.
How soon will I see noticeable results?
We have a 99% success rate in closing refluxing veins via EVLA treatment. This will not necessarily provide an acceptable cosmetic result, but the vast majority (more than 95%) of our patients are very happy with the symptom-relief and the cosmetic improvement following EVLA.
Symptoms should resolve before your follow-up appointment 6-8 weeks later in most cases, but cosmetic improvement takes longer.
Since most individuals need foam sclerotherapy, in addition to EVLA, in order to resolve all the visible varicosities, the full effect of the treatment typically becomes noticeable two or three months later.
We intend to make your legs look ‘normal’, and this may also necessitate multiple appointments, depending on the extent of your varicose veins. Your consultant will discuss with you the number of appointments you are likely to require and the timescales for visible results during your initial consultation.
Do treated varicose veins stay away for good?
We have a 99% success rate in closing refluxing veins via EVLA treatment. While we cannot guarantee that closed veins will not reopen at a later date, such instances are relatively uncommon and occur in only a small number of patients.
The risk of developing reflux in treated veins, following EVLA, is estimated to be around 1-2% per year.
This compares to 7 in 10 patients experiencing recurring varicose veins following surgical stripping. This is why UKVC promotes minimally invasive treatments, such as EVLA, which are far more effective long term.
Costs and payments
How much does it cost to treat varicose veins?
The cost of treating varicose veins is contingent on the severity of your condition and the specific type(s) of treatment needed.
During your initial consultation, a colour duplex ultrasound scan will be conducted to identify the underlying cause of your varicose veins. Subsequently, your consultant will discuss the most appropriate treatment options with you. Following the consultation, you will receive a comprehensive report along with a quotation for the recommended treatment.
Our treatment prices for EVLA and foam sclerotherapy sessions are fixed, and there are no hidden fees. You can find details of prices for all our vein treatments on our self-funded pricing page. We also work with many health insurance providers who may fund treatment if you have an underlying condition such as venous insufficiency.
How much does it cost to treat thread veins?
The primary method for treating thread veins is typically microsclerotherapy. For thread veins on the face, the recommended treatment is thermocoagulation.
Our pricing for microsclerotherapy and thermocoagulation sessions is set, with no additional charges. You can find details of pricing for all our vein treatments on our self-funded pricing page.
It’s important to note that multiple sessions may be necessary to effectively address your thread veins. Therefore, the overall cost can vary depending on the number of veins initially present and their response to treatment.
Typically, most individuals require 2-4 sessions to treat all visible thread veins.
Your consultant will discuss the recommended number of sessions with you during your initial consultation.
Will my health insurance cover the costs of treating varicose veins?
As varicose veins are not solely a cosmetic concern, many health insurance providers typically offer coverage for the costs of treatment. Upon receiving the results of your consultation, your insurer will assess your eligibility for treatment funding. The decision to fund your treatment ultimately rests with your insurer.
If an underlying valve issue is identified during the consultation, your insurance is likely to cover the treatment aimed at resolving it. However, if there is no underlying cause for your concerns and your veins are not causing symptoms, it is unlikely that your insurer will fund the treatment, especially for cosmetic reasons.
Unless your policy explicitly excludes varicose vein treatment, you should encounter no obstacles in choosing treatment from our vascular specialists. We have successfully treated numerous patients initially denied authorisation.
However, authorisation through insurance for thread vein treatment is highly unlikely, as it is generally considered cosmetic. Nevertheless, undergoing a colour duplex ultrasound scan is crucial to rule out the presence of venous reflux in larger, deeper veins that may contribute to the thread veins. This means your insurer may cover the costs of the initial consultation, but again, this decision rests with your insurer.
Why is the cost of EVLA treatment the same regardless of the number of veins requiring treatment?
Our pricing for EVLA remains consistent, whether a patient has one refluxing vein or multiple refluxing veins per leg in need of treatment. We avoid charging patients with a single refluxing vein excessively, and similarly, patients with multiple veins are not charged more than necessary.
The rationale behind this pricing approach lies in the fact that our overhead costs do not see a significant increase with the number of veins. The consumables used for EVLA, such as procedure packs, remain the same regardless of the number of veins being treated. Consultants are compensated at a consistent rate for each case, with the primary time difference being the procedural duration. The majority of the procedure time involves preparation before and after the procedure, which remains constant regardless of the number of veins treated.
While it might be justifiable to charge higher fees for patients with multiple veins undergoing EVLA, we choose not to do so. Our commitment is to maintain fair pricing that reflects our actual overheads. For patients with multiple sources of varicose veins, we prioritise ensuring reasonable costs rather than increasing charges when they already face more significant issues. This pricing approach does not imply higher charges for patients with a single vein in each leg; rather, it ensures that those with multiple veins are not subject to excessive fees.
Our commitment is to avoid unnecessary price inflation, even if other providers consider it reasonable to charge on a per-vein basis.
You can find details of prices for all our vein treatments on our self-funded pricing page.
Please explain your Unilateral vs Bilateral EVLA Prices?
Our pricing structure for unilateral and bilateral EVLA reflects a commitment to fairness and transparency. If you have refluxing veins on both legs, we do not charge the unilateral EVLA fee twice. Instead, we apply a premium to cover the additional costs incurred in treating two legs as opposed to one.
The decision to charge a premium for bilateral EVLA accounts for additional expenses such as consultant costs, consumables and procedure time. However, it’s important to note that these additional fees are not doubled. The majority of the procedure time is dedicated to preparation before and after the procedure, which remains consistent regardless of whether one or both legs require treatment.
Our approach is designed to ensure that patients with bilateral vein concerns are charged a fair and proportionate premium that accurately reflects the added expenses associated with treating both legs. This transparent pricing strategy aligns with our commitment to providing reasonable and justified costs for our services.
You can find more details of pricing for all our vein treatments on our self-funded pricing page.
Under what circumstances might treatment prices increase for individuals with a higher number of veins?
The sole scenario in which our fees for EVLA may increase is if the extent of your varicose veins necessitates a two-session approach, making it impractical to complete EVLA in a single sitting. In such rare instances, we charge the unilateral fee twice, but this occurs with less than 1% of our patients.
Another factor influencing the price for patients with more extensive veins is the number of sessions required for foam sclerotherapy to address all visible varicosities. The likelihood of needing multiple injection sessions increases with the number of visible veins, as safety limits restrict the amount of sclerotherapy that can be administered in a single session. Your consultant will discuss the recommended number of sessions with you during your initial consultation.
Treatment specialists
What is the difference between Consultant Vascular Surgeons and Consultant Interventional Radiologists?
At UKVC, our team comprises both Consultant Vascular Surgeons and Consultant Interventional Radiologists. All our specialists hold established positions as consultants (senior doctors in the UK) and possess extensive training in the clinical assessment of patients with venous disease, venous ultrasound scanning, as well as EVLA and foam sclerotherapy techniques.
Interventional radiologists specialise in providing image-guided therapies, often surpassing older open surgical procedures. Despite the specific specialty of the consultant, all our professionals undergo rigorous training in modern diagnostic and therapeutic techniques. Consequently, there is no distinction in the quality of vein treatment one would receive from a Consultant Vascular Surgeon or a Consultant Interventional Radiologist at UKVC.
What is the difference between vascular experts and venous experts?
A venous expert specialises in veins, whereas a vascular expert focuses on vessels, encompassing both arteries and veins. While most vascular specialists engage in some venous work, a significant portion of their practice may involve treating arterial diseases. When seeking vein treatment, it is crucial to consult with a professional who specialises specifically in vein care.
At UKVC, all our consultants are renowned experts in the field of treating veins, each having completed over 10,000 vein treatments. Their dedicated focus on venous care ensures a high level of expertise and specialisation in addressing various vein-related concerns.
What is an interventional radiologist?
Interventional radiologists are surgeons guided by modern imaging techniques. Their training background is in radiology, equipping them with the skills to interpret images and perform minimally invasive procedures, including the treatment of varicose veins.
Who is qualified to treat varicose veins?
Individuals qualified to treat varicose veins are those who specialise in venous disease, with a preference for those who are specifically vein (venous) specialists rather than general vascular specialists. While most patients are typically referred to Vascular Specialists, who can be either Vascular Surgeons or Interventional Radiologists with expertise in veins, the key is to consult with someone who has a special focus on vein disease.
At UKVC, all our consultants are seasoned experts in vein treatment, boasting over 10,000 completed vein treatments each. Their extensive experience and dedicated focus on veins ensure comprehensive and specialised care for patients with various vein-related concerns.
Are you regulated by anyone?
Our UKVC clinic in Dubai is licensed and regulated by the Dubai Health Authority (DHA). This means we must meet certain criteria and comply with regulations in regards to things like:
- Clinic accessibility, safety and cleanliness
- Patient safety and care
- Data management and confidentiality
- Equipment maintenance
- Medication management
This is assured via regular data submissions and periodic inspections. You can find out more on the DHA website.
Clinic policies
What is your cancellation policy?
If you need to cancel your appointment for any reason, please contact us to discuss this as soon as possible.
If you provide at least one week’s notice, ahead of your original appointment date, then the monies you have paid can be transferred to another appointment.
Anything else is at the discretion of the clinic manager.
We will not be able to transfer monies or refund you for last minute cancellations. This is because we will already have purchased the necessary medications for your treatment and paid our staff to come in that day.
What is your complaints procedure?
We have a well-established complaints procedure designed to promptly and effectively address any grievances for the benefit of all parties involved.
If you are dissatisfied with any aspect of the service or care provided to you, please share your concerns or provide feedback to any member of our clinic team at your earliest convenience. We encourage open communication to resolve issues quickly and informally.
Should your feedback not lead to a satisfactory resolution, you have the option to make a formal complaint. Written complaints can be submitted to the Clinic Manager, who will acknowledge receipt within two working days. Alternatively, you may choose to email your complaint to: info@uk-veincentre.com.
Your complaint will be acknowledged within two working days and we aim to come to an agreement regarding resolution within 7 working days.
UKVC is licensed and regulated by the Dubai Health Authority (DHA). If, for any reason, you are still not satisfied with the resolution of your complaint following these steps, you may submit your complaint to DHA who will advise of next steps.
Terminology
What are varicosities?
The meaning of varicose is ‘abnormally swollen or dilated’ and comes from the Latin word varix which means ‘twisted’.
Varicosity means ‘the state or condition of being varicose’. Varicosities, therefore, is another name for varicose veins.
What is a colour duplex ultrasound scan?
A colour duplex ultrasound scan is a painless, swift, and non-intrusive procedure that provides a comprehensive assessment of the anatomy (appearance) and physiology (functionality, such as blood flow direction) of your veins.
Similar to the ultrasound scans performed on pregnant women to monitor the health and growth of a baby, this scan is conducted on your legs while you are standing. It effectively identifies the presence of superficial venous reflux (reverse blood flow) in veins beneath the skin, indicating faulty valves and venous insufficiency.
Normally, the valves in your veins ensure one-way blood flow—from your feet to your heart. However, if these valves are defective, blood may flow back down the leg, leading to pooling and the appearance of visible varicose veins. As pressure increases, venous insufficiency and hypertension can develop, causing symptoms like discomfort, pain, skin changes, and, eventually, leg ulcers.
Even if clinical signs of reflux at the commonest site are evident, a colour duplex ultrasound scan is essential. This test can reveal additional details, such as further refluxing segments and variations in normal anatomy, influencing the optimal treatment plan.
It is crucial to exercise caution if offered treatment without a thorough colour duplex ultrasound scan, as a simple handheld Doppler examination may not accurately identify the root cause of your vein issues.
What is surgical stripping for varicose veins?
For many years, the primary treatment for varicose veins involved a surgical procedure known as ‘stripping’, involving physical removal of the problematic vein. This surgical intervention was invasive, requiring incisions and stitches, often performed under general anaesthetic. The recovery period typically involved several weeks off work for rest and recuperation.
While some patients did achieve positive outcomes with this varicose vein surgery, the reported recurrence rate was considerable, with as many as 7 in 10 patients encountering further issues.
Although this surgery is still commonly performed to resolve varicose veins, UKVC follow the recommendations of NICE in the UK, using EVLA and foam sclerotherapy as the preferred minimally invasive treatments to resolve varicose veins.
What is superficial venous reflux?
Within your veins, there are tiny valves that play a crucial role in ensuring blood flows in a single direction – upward from your feet to your heart. Superficial venous reflux emerges when the valves in your superficial veins (smaller veins closer to the skin’s surface) undergo damage or disease, resulting in their failure. This failure causes blood to reverse its course (backwards down your legs), causing the vein to become overloaded and enlarged, leading to blood pooling in your legs.
When one valve becomes damaged, the vein below is stretched and pulls apart the subsequent valve, initiating a domino effect. This cascade results in the failure of more valves, ultimately leading to venous insufficiency and the development of prominent varicose veins.
What is chronic venous insufficiency?
Chronic venous insufficiency (CVI) is a form of venous disease that occurs when veins in your legs are damaged. As a result, these veins can’t manage blood flow as well as they should, and it’s harder for blood in your legs to return to your heart. CVI causes blood to pool in your leg veins, leading to high pressure in those veins (venous hypertension).
This increased pressure in your leg veins causes symptoms like swelling, pain, varicose veins and leg ulcers.
CVI can happen due to damage in any of your leg veins. These include:
- Deep veins, which are large veins deep in your body that run through your muscle
- Superficial veins, which are smaller and closer to your skin’s surface
- Perforating veins, which connect your deep and superficial veins
CVI may cause mild symptoms at first. But over time, this condition may interfere with your quality of life and lead to serious complications.
Venous insufficiency can be triggered by:
- Valve failure, the most common cause of venous insufficiency and varicose veins, linked to inherited defects, hormonal changes (e.g. in pregnancy), or trauma
- Deep venous obstruction caused by conditions such as deep vein thrombosis (DVT) or pelvic tumours
- Muscle pump failure, occurring when calf muscles are weak, leading to valve failure if it persists
The most prevalent factor in venous insufficiency is valve failure.
At its mildest, venous insufficiency produces thread veins (also called spider veins), which are mainly cosmetic, with possible associated aching. Slightly larger blue veins, known as reticular veins, may also develop. More severe cases result in common varicose veins, and in 20% of individuals over 65 years old it can lead to skin changes and ulcers.
Detecting, localising and treating reflux are vital for managing venous insufficiency issues, including varicose veins, reticular veins, thread veins, and leg ulcers.
The stages of CVI include:
- Stage 0: Veins show signs of superficial venous reflux. Valves within superficial veins become damaged and blood starts to flow backwards. No outward signs that can be seen or felt. You may feel symptoms like achy or tired legs.
- Stage 1: Multiple valve failures cause early venous insufficiency. You may develop visible blood vessels, including thread (spider) veins.
- Stage 2: Chronic venous insufficiency causes blood to pool in leg veins, causing varicose veins at least 3 millimeters wide.
- Stage 3: Continued build up of blood in leg veins causes venous hypertension (increased pressure) and oedema (swelling) but no skin changes.
- Stage 4: Excessive hypertension causes changes to your skin’s colour and/or texture e.g. pigmentation changes, venous eczema, burst capillaries.
- Stage 5: Visible but healed ulcer(s) may appear on the legs.
- Stage 6: Acute (active) ulcer(s) (open sores) are clearly visible on the legs.
You’ll be diagnosed with chronic venous insufficiency if you’re at stage 3 or above.
In other words, having varicose veins doesn’t mean you have CVI. But varicose veins are a sign of blood flow problems that could get worse over time. So, it’s important to tell your health care provider about any new varicose veins you notice.
What is venous hypertension?
Venous hypertension is a medical condition that occurs when the pressure inside your leg veins becomes too high, due to weakened vein valves and blood pooling in the legs. Venous hypertension is one of the conditions that might arise due to (chronic) venous insufficiency, alongside varicose veins.
Unlike arterial hypertension, which is commonly known as high blood pressure, venous hypertension specifically affects the veins in the legs. If left untreated, chronic venous hypertension can cause discomfort, swelling, pain and skin changes. In severe cases, it can lead to the formation of blood clots or venous leg ulcers. It’s important to seek medical attention if you experience any symptoms of this condition.
Venous leg ulcers are caused by sustained venous hypertension, which results from chronic venous insufficiency due to venous valve incompetence or impaired calf muscle pump function.
What is a sclerosant?
A sclerosant, or sclerosing agent, is a chemical compound that acts as an irritant to the lining of the vein wall.
In our sclerotherapy procedures, we use sodium tetradecyl sulphate (STS) as a liquid sclerosant.
STS is a prescription-only licensed drug and is considered exceptionally safe when employed as a sclerosant. It has a long-standing history of safe usage in the treatment of varicose veins and thread veins.
Its administration is strictly regulated, requiring a doctor’s prescription and supervision due to a defined safety limit on the dosage administered in a single session. All our sclerotherapy sessions adhere rigorously to prescribed guidelines regarding the maximum allowable doses of the sclerosant.
STS works by targeting and eliminating the cells that constitute the lining of the vein wall. By depriving the vein of its protective lining, the vein collapses and undergoes cell death.
The drug used in microsclerotherapy is the same as used in foam sclerotherapy. The only difference is that in our foam sclerotherapy procedures, STS is combined with water and air to generate foam, which enhances the closure effectiveness of larger veins.
What is telangiectasia?
Telangiectasia is a condition in which there are visible small linear red blood vessels (broken capillaries). These are also called telangiectases. Visible small blood vessels that are blue in colour are sometimes called venulectasia because venules are involved.
Since thread veins (or spider veins) can vary in appearance, both telangiectasia and venulectasia can be considered types of thread veins.
What is telangiectatic matting?
Telangiectatic matting is a rare complication of sclerotherapy involving the development of a new cluster of thread veins less than 0.1 mm in diameter.
Telangiectatic matting occurs if fragile blood vessels are injured during treatment, leaving a mat of tiny veins that look like a bluish or a red bruise, most commonly on the inside of the knee.
Matting usually disappears completely after 6 – 12 months, but if it persists, it can be treated with microsclerotherapy by using a very fine needle to treat these veins.
What is skin staining?
Skin staining, also referred to as hyperpigmentation or haemosiderin staining, is a potential side effect of foam sclerotherapy and microsclerotherapy, occurring in approximately 10% of patients.
The word siderin is Greek for iron. Haemosiderin is a protein that stores iron in our blood and tissues, and can accumulate in the blood under certain circumstances. Once accumulated, it can cause brown or black staining or a bruise-like appearance.
While not posing a health risk, it can lead to an unsatisfactory cosmetic appearance, especially in the short term. Typically skin staining manifests within 4-6 weeks of treatment, it usually resolves within 6 months in 60% of cases and within 1 year in 95% of cases.
However, in 1-2% of cases, it may take 12-18 months to fade. While we cannot guarantee the absence of permanent marks, such occurrences are fortunately rare.
What is phlebitis?
Phlebitis refers to the inflammation of a vein. It describes the process when veins become swollen, bulging and inflamed due to blood clotting inside of the vein, or because the vein walls are damaged. Phlebitis can occur in both superficial veins that are closer to the skin’s surface, or deeper veins. These veins can become sore, red, itchy and tender, and may develop an infection if the blood clot is severe, leading to deep vein thrombophlebitis.
Superficial thrombophlebitis, which affects shallow veins is rarely serious, but may develop into deep vein thrombophlebitis (also called deep vein thrombosis (DVT)). This describes clotting in the larger and deeper blood vessels that usually rest in the legs. Large blood clots can form, which may break off and travel to the lungs. This is a serious condition called pulmonary embolism (PE) and requires immediate medical attention.
What is venous thromboembolism (VTE)?
Venous thromboembolism (VTE) is a condition that occurs when a blood clot forms in a vein. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE).
What is deep vein thrombosis (DVT)?
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the lower leg, thigh, or pelvis. DVT usually presents as a swollen (3cm > pre-treatment) painful calf and requires urgent review by a medical professional (including out-of-hours if required). If DVT is suspected you will usually be given a blood-thinner and a scan arranged the following day.
What is pulmonary embolism (PE)?
Pulmonary embolism (PE) is a blood clot that blocks and stops blood flow to an artery in the lung. In most cases, the blood clot starts in a deep vein in the leg and travels to the lung. PE is a serious condition and needs to be urgently diagnosed and treated and can occur without leg swelling. Any new shortness of breath is a red-flag symptom and would warrant urgent review at your nearest Emergency Department (ED).
