With varicose veins, the veins lengthen and dilate, and nodular deformities appear on them.At the same time, the functioning of the valve apparatus is disrupted, which leads to disruption of blood flow in the affected vein.
Varicose veins not only lead to a pronounced cosmetic defect, but may 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 vein thrombosis may develop.
Symptoms include dilation, tortuosity 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 quite quickly and easily.There are several methods for getting rid of 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 tightly fixed thrombotic “seal” is formed in the vein, which stops blood flow in the vessel.As a result, the vein gradually dissolves.
The drug is administered both under visual control and under ultrasound control.This allows you to 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, the patient is recommended to wear compression stockings for several weeks or even months.Repeated administration of sclerosant is often required; in this case, they talk about conducting a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is used only to remove intradermal spider veins.When removing saphenous veins, the technique is used as an addition to other methods (EVLT, RFA, traditional operations) for removing small-diameter venous ducts.
Closing veins with biological glue
A special drug successfully closes veins at 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, upon contact with blood, polymerizes, squeezes out the blood and forms a polymer “seal.”After the cessation of blood flow through the vein, as with sclerotherapy, fibrous tissue is formed and the vessel is partially resorbed.The 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 for the removal of large main veins and for the removal of smaller but deeply located veins, for example, perforators.
The procedure is performed with 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 resolves.
The effect of the laser can be compared to removing 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, superficially located intradermal vessels (usually capillaries, venules or arterioles).The disadvantages of the method are frequent relapses and burns.
By the way, the cost of laser treatment for varicose veins is generally lower than the price of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Only large veins are removed using radiofrequency ablation.The method is fundamentally similar to laser removal, however, with RFA, the effect on the veins is not a laser, but a very high (radio wave) frequency current.
The RFA technique is effective, but it has a big disadvantage - a considerable price (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The operation is shown:
- if desired by the patient;
- in the presence of some anatomical features 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 surgery to treat varicose veins (phlebectomy) has also changed today.
If previously, to remove a diseased vein, it was necessary to make incisions along the entire length of the 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 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 have 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, less often 3 mm), the veins are grabbed with special “hooks” that look like crochet hooks and pulled out, where they are crossed and removed in fragments.
This procedure is performed under either local anesthesia or general anesthesia.The disadvantages of the procedure are labor intensity, the inability to remove deep and large trunks, and a high percentage of residual veins and their fragments.Today this technique is used as an addition 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 select a treatment package depending on the anatomical features 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 desires of the patient.