With varicose veins, the veins are elongated and enlarged, and nodular defects appear on them.At the same time, the function of the valve device is disrupted, which leads to disruption of blood flow in the affected vein.
Varicose veins not only lead to significant cosmetic defects, but can also be accompanied by disturbances in the movement of blood to the heart, its stagnation in organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and vein thrombosis may develop.
Symptoms include dilation, confusion of veins with the formation of nodes, spider veins or spider veins, intermittent and then permanent swelling, bronze color of the legs, inflammation of the skin and subcutaneous fat, and the development of trophic ulcers.
Fortunately, today there are ways to treat varicose veins that do not require surgery.
Modern treatment without surgery
The essence of all procedures is to remove varicose veins.In recent years, phlebology (the science of treating veins) has changed a lot, and today you can get rid of varicose veins quickly and easily.There are several methods to eliminate vein pathology:
- Sclerotherapy.
- Use of biological glue.
- Laser freezing.
- Radiofrequency ablation.
- Traditional operation.
- Miniphlebectomy.
Sclerotherapy
The essence of the technology is the preparation of a special liquid, sclerosant, injected into the diseased vein through a small puncture with a syringe.
A tight thrombotic "seal" forms in the vein, which stops blood flow in the vessel.As a result, the veins gradually dissolve.
This medicine is given under visual control and under ultrasound control.This allows you to make sclerosis vessels invisible on the surface and control the spread of the drug through the vessels.
To consolidate the effect after the administration of sclerosant, patients are recommended to wear compression stockings for several weeks or even months.Repeated administration of the sclerosant is often required;in this case, they are talking about conducting a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is only used to remove intradermal spider veins.When removing the saphenous vein, this technique is used in addition to other methods (EVLT, RFA, traditional operation) to remove small diameter venous vessels.
Seal the veins with biological glue
Special drugs successfully close the veins at various stages of varicose veins.The procedure is similar to the previous one, but in this case an adhesive material is inserted into the lumen, which, when in contact with blood, polymerizes, squeezes the blood and forms a polymer "seal".After the cessation of blood flow through the vein, as with sclerotherapy, fibrous tissue forms and the vessel is partially reabsorbed.Materials for this procedure are quite expensive.
Laser coagulation (EVLC)
Lasers are used in two ways:
Endovenous laser coagulation/ablation/obliteration or EndoVenous Laser Therapy (EVLK, EVLA, EVLO, EVLT) is used for both removal of large major veins and for removal of smaller veins but located in, for example, perforators.
The procedure is performed under local anesthesia and takes from 20 minutes to an hour.A laser light guide is inserted into the vein through a small puncture, and with the help of light energy, coagulation ("folding") of blood proteins is caused, forming a protein-erythrocyte coagulum ("seal") in the lumen, which blocks the lumen of the vessel.
After the cessation of blood flow, the lumen of the vein grows with fibrous tissue, then it gradually closes.
The effect of a laser can be compared to removing veins.Patients can go home immediately after surgery and wear compression stockings for several weeks or months.
Percutaneous laser coagulation (PLC).In this case, the vein is targeted directly through the skin with a focused laser beam.This method only removes very thin intradermal vessels, less than 0.1 mm, located superficially (usually capillaries, venules or arterioles).The downside of this method is repetition and burnout.
In this way, the cost of laser treatment for varicose veins is generally lower than the price of the previous method.
Radio frequency ablation/removal (RFA, RFO)
Only large veins are removed using radiofrequency ablation.This method is basically similar to laser removal, however, with RFA, the effect on the vein is not a laser, but a very high frequency current (radio waves).
The RFA technique is effective, but it has a major drawback - a relatively high price (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The operation is shown:
- if desired by the patient;
- with the presence of some structural anatomical features of large veins that prevent minimally invasive intervention (EVLT, RFA);
- with estial thrombosis of a large venous trunk.
Fortunately, the way we perform surgery to treat varicose veins (phlebectomy) has also changed today.
If before, to remove a diseased vein, it was necessary to make an incision along the entire leg, today it is enough to make two small incisions (sometimes one is enough) and remove a large vein using a special probe.
This not only preserves the beauty of the legs (does not leave a very noticeable scar), but also makes the operation itself less traumatic and the recovery period faster.
If the case is not very advanced, you do not need to go to the hospital for surgery, but go home after the anesthesia wears off.
Miniphlebectomy
It consists in the fact that through a small puncture of the skin (up to 1-2, less often 3 mm), the vein is caught with a special "hook" that looks like a crochet hook and pulled out, where it is crossed and removed in fragments.
This procedure is performed either under local anesthesia or general anesthesia.The disadvantages of the procedure are the labor intensity, the inability to remove deep and large stems, and the high percentage of residual vein and debris.Today this technique is used in addition to EVLT, RFA or traditional surgery.
Both minimally invasive and traditional surgical methods provide approximately the same results, which depend mainly on the stage of advanced disease.To achieve better treatment results, a combination of several methods is used, for example, EVLT and sclerotherapy or miniphlebectomy, RFA and sclerotherapy, surgery and miniphlebectomy, etc.
Only an experienced doctor can choose a treatment package depending on the anatomical characteristics of varicose veins, the level and severity of the disease, the presence of complications, general health conditions, taking into account the personal needs and wishes of the patient.