To answer your questions -
1 Usually this therapy is for
deep vein thrombosis (femoral, popliteal, iliac,
inferior vena cava). The saphenous vein is not considered a deep vein, which is why she was not placed on it for a longer period of time.
2. The usual dose of aspirin is 81mg daily. This is a standard dose usually used by both cardiologists and vascular surgeons.
3. Plavix can be used, however this is usually reserved for patients who have had cardiac or vascular stents placed, or patients with severe
vascular disease. This will increase bleeding risk. Of note, plavix and aspirin do not affect the number of platelets that one has, they affect the function of platelets. The best test to see the effect aspirin or plavix has is either
bleeding time or platelet function assays.
4. Statins have been well studied and have beneficial effects. There is no evidence shown that Krill Oil is equivalent or superior to statins. If your mother does not have any contraindications to statins (liver disease for example), then I would recommend she continue with the statins, as they have also been shown to have cardiac protective effects in multiple studies.
5. She should continue to have ultrasounds of her bilateral lower extremities.
6. She should walk as much as possible! There is no limitation. Walking is great treatment for
varicose veins as well as her overall health.
7. Blood clots will usually not dissolve, they will scar and become part of the vessel. However, your body will tend to use collaterals (think of it as taking side streets when the main road is blocked).
8.
Laser ablation can be an effective treatment for varicose veins, however your mother should have a patent deep vein system in order for this to be effective. Make sure she has a recent ultrasound of her leg in order to asses this.
9. There is no hurry here. Varicose veins are usually treated for symptoms, not to prevent other clots forming. Clots in varicose veins will not lead to deep
venous thrombosis. There is no risk of the clot migrating to another vein during the treatment
In summary, I would have your mom continue her aspirin and her statin, get her to walk and wear her compression stockings as much as possible. If she is a candidate for laser ablation, it may help her symptoms with her varicose veins. There is no risk of clots in these veins going to her lungs, and we usually do not put people on long term anticoagulation for this.
I hope this is helpful!