When varicose veins occur, 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 interruption of blood flow in the affected vein.
Varicose veins lead not only to obvious cosmetic defects, but can also be accompanied by disorders of blood movement to the heart, stagnation in organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and venous thrombosis may develop.
Symptoms include dilatation, tortuosity of the 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, as well as the development of trophic ulcers.
Fortunately, today there are many ways to treat varicose veins without surgery.
Modern treatment does not require surgery
The essence of all procedures is to eliminate 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 to eliminate venous pathologies:
- Sclerotherapy.
- Application of bio-adhesive
- Laser coagulation.
- Radiofrequency ablation.
- Traditional activities.
- Removal of small veins.
Sclerotherapy
The essence of this technology is that a special liquid preparation, a sclerosing agent, is injected into the diseased vein through a small puncture with a syringe.
A tightly fixed thrombotic “seal” is formed in the vein, stopping blood flow in the vessel.As a result, the veins gradually disappear.
The drug is administered under visual control and under ultrasound control.This allows you to harden invisible blood vessels on the surface and control the spread of the drug through the blood vessels.
To consolidate the effect after sclerotherapy, the patient should wear compression stockings for several weeks or even months.It is often necessary to use sclerosing agents multiple times;in this case, they talk about carrying out a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is only used to remove spider veins in the skin.When removing the saphenous vein, this technique is used as a complementary method to other methods (EVLT, RFA, traditional surgery) to remove small diameter venous ducts.
Close the vein with biological glue
A special drug helps to successfully close 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, when in contact with blood, polymerizes, squeezing the blood out and forming a polymer “seal”.After stopping venous blood flow, as with sclerotherapy, fibrous tissue is formed and the blood vessels are partially resorbed.The materials for this procedure are quite expensive.
Laser coagulation (EVLC)
Lasers are used in two ways:
Endovenous laser coagulation/ablation/ablation or Endovenous Laser Therapy (EVLK, EVLA, EVLO, EVLT) is used both for the removal of large major veins and for the removal of smaller but deep veins, such as perforator veins.
The procedure is performed using local anesthesia and takes 20 minutes to an hour.A laser light guide is inserted into the vein through a small hole, and with the help of light energy, coagulation (“folding”) of blood proteins is induced, forming a protein-red blood cell coagulation (“seal”) in the lumen, blocking the vessel lumen.
After stopping blood circulation, the vein lumen develops with fibrous tissue, which then gradually dissolves.
The effects of 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 using a focused laser beam.This method only removes very thin blood vessels, less than 0.1 mm, located on the surface of the skin (usually capillaries, veins or arterioles).The disadvantage of the method is frequent recurrence and burns.
By the way, the cost of laser treatment for varicose veins is usually lower than previous methods.
Radio frequency ablation/ablation (RFA, RFO)
Only large veins are removed by radiofrequency ablation.This method is essentially similar to laser removal, however, with RFA, the impact on the vein is not a laser, but an electric current of very high frequency (radio waves).
The RFA technique is effective but has a major drawback - high cost (due to high costs of equipment and consumables).
Surgical treatment – vein removal
Activities displayed:
- if desired by the patient;
- in the presence of certain anatomical features of large venous structures that prevent minimally invasive interventions (EVLT, RFA);
- with large venous thrombosis of the large venous trunk.
Fortunately, the way we perform varicose vein surgery (phlebectomy) today has also changed.
If in the past, to remove a diseased vein, one had to make an incision along the entire length of the leg, today it is enough to make two small incisions (sometimes one is enough) and remove large veins with a special probe.
This not only preserves the beauty of the legs (leaving no noticeable scars) but also makes the surgery less traumatic and recovery time faster.
If the case is not very advanced, you do not even need to go to the hospital for surgery but will go home after the anesthesia wears off.
Removal of small veins
It consists in the fact that through small punctures in the skin (up to 1-2, less than 3 mm), the veins are captured by special "hooks" that look like hooks and pulled out, where they are criss-crossed and removed in pieces.
This procedure is performed under local or general anesthesia.The disadvantages of the procedure are the labor intensity, the inability to remove deep and large stems, the high incidence of residual veins and their fragments.Today this technique is used as a complement to EVLT, RFA or traditional surgery.
Both traditional and minimally invasive surgical methods give approximately the same results, mainly depending on the degree of disease progression.To achieve better treatment results, a combination of several methods is used, for example EVLT and sclerotherapy or small vein ablation, RFA and sclerotherapy, surgery and small vein ablation, etc.
Only an experienced doctor can choose a treatment package depending on the anatomical features of varicose veins, the extent and severity of the disease, the presence of complications, the general state of health, taking into account the individual needs and desires of the patient.