In varicose veins, the veins lengthen and expand and nodular deformations form on them.At the same time, the function of the valve apparatus is disrupted, which leads to disruption of blood flow in the affected vein.
Varicose veins lead not only to a pronounced cosmetic defect, but can also be accompanied by disorders of blood flow to the heart, its stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and venous thrombosis can occur.
Symptoms include dilatation, tortuous veins with the formation of nodules, spider veins or spider veins, temporary and then permanent swelling, bronze coloring of the legs, inflammation of the skin and subcutaneous fatty tissue, and the development of trophic ulcers.
Fortunately, today there are options for treating varicose veins that do not require surgery.
Modern treatment without surgery
The core of all procedures is the removal of varicose veins.In recent years, phlebology (the science of treating veins) has changed significantly and today you can get rid of varicose veins quickly and easily.There are several methods to get rid of venous 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 stuck thrombotic “occlusion” forms in the vein, stopping blood flow in the vessel.This causes the vein to gradually dissolve.
The drug is administered under both visual and ultrasound control.This allows you to destroy vessels that are 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 necessary;In this case, one speaks of carrying out sclerotherapy, which consists of several sessions.
Nowadays, sclerotherapy is only used to remove intradermal spider veins.When removing saphenous veins, the technique is used as an adjunct to other methods (EVLT, RFA, traditional operations) for the removal of small diameter venous ducts.
Seal veins with biological glue
A special drug successfully closes veins in various 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, pushing the blood out and forming a polymer “seal”.After the blood flow through the vein stops, as in sclerotherapy, fibrous tissue forms and the vessel is partially reabsorbed.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 to remove large main veins and to remove smaller but deeper veins, such as perforating veins.
The procedure is performed under local anesthesia and takes between 20 minutes and an hour.A laser light guide is inserted into the vein through a small puncture and with the help of the light energy, blood proteins coagulate (“fold”), resulting in the formation of a protein-erythrocyte coagulum (“seal”) in the lumen, which closes the lumen of the vessel.
After the cessation of blood flow, the lumen of the vein grows with fibrous tissue and then gradually dissolves.
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).The vein is targeted directly through the skin with a focused laser beam.With this method, only very thin, superficial intradermal vessels (usually capillaries, venules or arterioles) less than 0.1 mm in size are removed.The disadvantages of the method are frequent relapses and burns.
By the way, the cost of laser treatment of varicose veins is usually lower than the cost of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Only large veins are removed using radiofrequency ablation.The method is fundamentally similar to laser removal, but the effect of RFA on the veins is not a laser, but rather a current with a very high (radio wave) frequency.
The XRF technique is effective, but has one major drawback - a significant price (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The process is displayed:
- if requested by the patient;
- in the presence of some anatomical features of the structure of large veins that prevent minimally invasive procedures (EVLT, RFA);
- with essential thrombosis of large venous trunks.
Fortunately, today the way we perform operations to treat varicose veins (phlebectomy) has also changed.
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 time shortened.
If the case is not very advanced, you don't even have to go to the hospital for the operation; you can go home after the anesthesia wears off.
Miniphlebectomy
It consists in the fact that through small punctures in the skin (up to 1-2, less often 3 mm), the veins are captured and pulled out with special “hooks” that look like crochet hooks, where they are crossed and removed in fragments.
This procedure is performed under either local or general anesthesia.The disadvantages of the procedure are the laboriousness, the inability to remove deep and large trunks, as well as a high proportion of remaining 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 provide 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, general health and taking into account the patient's personal needs and wishes.