Swollen veins seem to be a chicken-and-egg thing. Perhaps the clot caused some backup, which caused veins to swell and become sinuous. Once treated, your over-all health became repaired but veins do not repair to the same extent, or much hardly at all. Once the veins and valves become damaged, provide fertile clot territory, and do not move the blood, then comes the risk of more clotting.
By far the simplest remedy for venous insufficiency is to use compression stockings. Knee high ones are most common, and there was an interesting thread going at http://www.dailystrength.org/c/Deep_Vein_Thrombosis_DVT/forum/6447883-knee-high-v-thigh-high . Beyond that, there are some surgical options where neither money nor bureaucratic rules are issues. In my own case, the more visible damage is further down the leg, but what you see may be only the tip of the iceberg. Much of my migrated damage extends up the Popiteal and Superficial Femoral all the way to the groin, though the swelling is only below the knee. Nonetheless, knee-high compression seems to work as far as that it keeps the swollen unsightliness down.
I figure even if I made it my mission to get all the most specialized surgery for vein and valve repair, I would still have the chronic lung vessel damage and would still have the underlying clot mutation; possibly with damage from surgery, so I just leave it well alone.
Some others may have gone under the knife and had particular experience.

Hi I too have had a PE which appears to have been caused by varicose veins, in exactly the way you describe above. I hope that blood tests after I come off Warfarin will show that I am not predisposed to clots which means that I may have a singular cause of my DVT and PE. I have gone to my GP to be referred to a specialist who deals with varicose veins. It seems the best way to check what damage you have to your valves and to look at the blood flow through the legs is via an injected dye, which is not very pleasent (sorry can't remember name of procedure) but shows up the blood flow excellently. This should show whether the VVs should or not should be treated or as More2be says compression stockings will do.

In your case it seems as if you have more than one risk factor due to the Protein S deficiency so the decision for you seems complicated. However, my own personal view is that I intend to have the veinal test and make decisions based on that. good luck

I have varicose veins in both legs. My doc who treated me for the DVT/PE said they didn't cause my DVT specifically. But clearly I have circulation issues.

My doc recommended NOT getting the clots treated through laser or surgery. He said doing so can actually make your DVT leg permanently swell.

Note this doc is a Cardiologist and not a vascular doc, so there might be a difference of opinion between the two.

I had a few varicose veins prior to DVT but docs say to expect more since DVT due to valve problems. I have also had problems with superficial venous clots prior to this latest DVT/PE. I have been told the compression stockings are the way to go and use them faithfully daily.

I'm glad to see your posts. I had posted this topic on the varicose veins and the dvt forums a few months ago.

I have been dealing with varicosed veins in my left leg for 12 yrs. Have used compression socks faithfully. However, prior to DVT/PE I was having chronic phlebitis and thrombo-phlebitis even while using compressions socks and modifying my lifestyle (elevating my legs, walking a lot, not standing etc). The phlebitis unforfunately masked the DVT symptoms another words I didn't run to ER because i had been told by DRs that the superficial clots will not kill me. Well, I had multiple PEs hit both lungs in Jan.

Since then I have been gathering more info on the topic. Most Drs are not willing to say the varicosed veins caused the DVT. My OBGYN felt there was a strong connection. Anyway, an effective method approved by FDA in the USA is www.venacure.com . However, this does not resolve the fact that the veins involved in the DVT are usually compromised. I'm still planning to go to a vascular surgeon center after my 6 months on warfarin and see if there is any hope of relief offered by the procedure.

I would like to hear from anyone else that may have had the venacure procedure and especially if they also have had a DVT.