In varicose veins, the veins lengthen and widen, and nodular deformities appear on them.At the same time, the functioning of the valve apparatus is disturbed, which leads to a disturbance of blood flow in the affected vein.
Varicose veins not only lead to a pronounced cosmetic defect, but can also be accompanied by disturbances in the movement of blood to the heart, its stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and venous thrombosis can develop.
Symptoms include enlargement, tortuosity of the veins with the formation of nodules, 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 the removal of varicose veins.In recent years, phlebology (the science of treating veins) has changed a lot, and today you can get rid of varicose veins quite quickly and easily.There are several methods for removing vein pathologies:
- Sclerotherapy.
- Application of biological glue.
- Laser coagulation.
- Radiofrequency ablation.
- Traditional operations.
- Miniphlebectomy.
Sclerotherapy
The essence of the technology is that a special liquid preparation, a sclerosant, is injected into the diseased vein through a small puncture with a syringe.
A firmly fixed thrombotic "seal" is formed in the vein, which stops the flow of blood in the vein.As a result, the vein gradually dissolves.
The drug is administered both under visual control and under ultrasound control.This allows you to sclerose blood vessels invisible on the surface and control the spread of the drug through the blood vessels.
In order to consolidate the effect after the application of the sclerosant, the patient is recommended to wear compression stockings for several weeks or even months.Repeated application of the sclerosant is often required;in this case they are talking about conducting a sclerotherapy course consisting of several sessions.
Today, sclerotherapy is used only to remove intradermal spider veins.When removing saphenous veins, the technique is used as an adjunct to other methods (EVLT, RFA, traditional operations) to remove small-diameter venous channels.
Closure of veins with biological glue
A special medicine successfully closes veins in different stages of varicose veins.The procedure is similar to the previous one, but in this case, an adhesive substance is introduced into the lumen, which polymerizes in contact with blood, squeezes out the blood and forms a polymer "seal".After the cessation of blood flow through the vein, as in sclerotherapy, fibrous tissue is formed and the vein is partially resorbed.Materials for this procedure are quite expensive.
Laser Coagulation (EVLC)
The laser is used in two ways:
Endovenous laser coagulation/ablation/obliteration or endovenous laser therapy (EVLK, EVLA, EVLO, EVLT) is used both to remove large major veins and to remove smaller but deeply located veins, for example, perforators.
The procedure is performed under local anesthesia and lasts from 20 minutes to an hour.The laser light guide is introduced into the vein through a small puncture and with the help of light energy, coagulation ("overlapping") of blood proteins occurs, whereby a protein-erythrocyte coagulum ("seal") is formed 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 and then gradually recedes.
The effect of the laser can be compared to the removal of a vein.The patient 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 removes only very thin, less than 0.1 mm, superficial intradermal vessels (usually capillaries, venules or arterioles).Disadvantages of the method are frequent relapses and burns.
Otherwise, the cost of laser treatment of varicose veins is generally lower than the cost of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Radiofrequency ablation only removes large veins.The method is basically similar to laser removal, however, with RFA, the effect on the veins is not a laser, but a very high (radiowave) frequency current.
The RFA technique is effective, but has a major drawback - significant cost (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The operation is shown:
- at the request of the patient;
- in the presence of some anatomical characteristics of the structure of large veins that prevent minimally invasive interventions (EVLT, RFA);
- with estial thrombosis of large venous trunks.
Fortunately, the way we perform operations for the treatment of varicose veins (phlebectomy) has also changed today.
If earlier it was necessary to make incisions along the entire length of the leg to remove the diseased vein, 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 (it does not leave very noticeable scars), but also makes the operation itself less traumatic and the recovery period faster.
If the case is not very advanced, you don't even need to go to the hospital for surgery, but go home after the anesthesia wears off.
Miniphlebectomy
It consists in the fact that through small punctures of the skin (up to 1-2, rarely 3 mm) the veins are caught with special "hooks" that look like crocheted hooks and pulled out, where they are crossed and removed in fragments.
This procedure is performed under local or general anesthesia.Disadvantages of the procedure are work intensity, impossibility of removing deep and large trunks, and a high percentage of residual veins and their fragments.Today, this technique is used as an adjunct to EVLT, RFA or traditional surgery.
Both minimally invasive and traditional surgical methods give approximately the same results, which mainly depend on the degree of advanced disease.To achieve better treatment results, combinations of several methods are 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 degree and severity of the disease, the presence of complications, the general state of health, taking into account the personal needs and wishes of the patient.