With varicose veins, the veins lengthen and expand, node defects appear on it. In parallel, the work of the valve device is disrupted, this causes a violation of blood flow to the affected veins.
Varicose veins not only cause significant cosmetic defects, but can also be accompanied by disruption of blood flow to the heart, its stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers. In addition, inflammation and venous thrombosis can develop.
Symptoms are expansion, torture of the veins with the formation of varicose veins, vascular "stars" or "mesh", transient and then permanent edema, bronze foot color, inflammation of the skin and subcutaneous fat, 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 the veins that are altered by 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 get rid of venous pathology:
- Application of biological glue.
- Laser freezing.
- Radio frequency ablation.
- Traditional operation.
The essence of the technology is the preparation of a special liquid, sclerosant, injected into a diseased vein through a small puncture with a syringe.
A tightly fitted thrombotic "filling" forms in the vein, which stops blood flow in the vessel. As a result, the veins gradually dissolve.
The drug is administered under visual control and under ultrasound control. This makes it possible to harden invisible vessels on the surface and control the spread of the drug through the vessels.
To consolidate the effects after sclerosant injections, patients are recommended to wear compression socks for weeks or even months. Repeated sclerosant administration is often required; in this case, they talked about a course of sclerotherapy, which consisted 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 (EVLK, RFA, traditional surgery) to remove small -diameter venous ducts.
Vein closure with biological glue
The veins are successfully closed with special preparations at different levels of varicose veins. The procedure is similar to the previous one, but in this case the adhesive material is injected into the lumen, which, when in contact with blood, polymerizes, removes the blood and forms a polymer "filling". Upon cessation of blood flow through the veins, such as sclerotherapy, fibrous tissue is formed and vessels are partially absorbed. The materials for this procedure are quite expensive.
Laser freezing (EVLK)
Lasers are used in two ways:
Endovenous laser coagulation / ablation / removal or EndoVenous Laser Therapy (EVLK, EVLA, EVLO, EVLT) - is used to remove large major veins and to remove smaller veins but located inside, for example, a perforator.
The procedure is performed under local anesthesia and takes 20 minutes to an hour. Laser light indications are inserted through small punctures into veins, and with the help of light energy they cause clotting ("folding") of blood proteins, forming a protein-erythrocyte coagulum ("filling") in the lumen, which blocks the vessel lumen.
Upon cessation of blood flow, the venous lumen grows with fibrous tissue, then gradually dissolves.
The effect of the laser can be compared to the removal of a vein. Patients can go home immediately after surgery, and wear compression stockings for weeks or months.
Percutaneous laser freezing (PLC). In this case, the veins act directly through the skin with a focused laser beam. This method only removes very thin intradermal ducts, less than 0. 1 mm, located on the surface (usually capillaries, venules or arterioles) The disadvantage of this method is recurrence and burning.
By the way, the cost of laser treatment of varicose veins is generally lower than the price of previous methods.
Radio frequency deletion / deletion (RFA, RFO)
Only large veins are removed by radio frequency ablation. The method is essentially similar to laser removal, however, with RFA, the effect on the vein does not occur with a laser, but with a very high frequency current of radio waves.
The RFA technique is effective, but has a major drawback - a fairly large price (due to the high cost of equipment and consumables).
Surgical Treatment - Phlebectomy
- if desired by the patient himself;
- in the presence of several anatomical features of large vein structure, which prevent minimally invasive intervention (EVLK, RFA);
- with pre-oral thrombosis of large venous trunks.
Fortunately, the way to perform surgery to treat varicose veins (phlebectomy) has also changed today.
If earlier, to get rid of a sore vein, it was necessary to make incisions along the 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 foot (leaving no very noticeable scars), but also makes the operation itself less traumatic, and the recovery period faster.
If the case is not ignored, you can’t even go to the hospital for surgery, but go home after the anesthesia has passed.
This is due to the fact that through small punctures in the skin (up to 1-2, more rarely 3 mm), the vein is captured with a special "hook" that looks like a crochet hook, and pulled out, where it is crossed and removed in fragments.
The procedure is performed either under local or general anesthesia. The disadvantages of this procedure are the hard work, the inability to remove deep and large stems, the high percentage of vein waste and debris. Today this technique is used in addition to EVLK, RFA or conventional operations.
Both invasive and traditional surgical methods give almost identical results, which depend primarily on the degree of disease neglect. To achieve the best treatment results, a combination of several methods is used, for example, EVLK and sclerotherapy or miniflebectomy, RFA and sclerotherapy, surgery and miniflebectomy, etc.
Only an experienced doctor can choose a complex of treatment depending on the anatomical features of varicose veins, the degree and severity of the disease, the presence of complications, general state of health, taking into account the personal needs and desires of the patient.