With varicose veins, the veins become elongated and dilated, and nodular deformities appear in them.At the same time, the functioning of the valve apparatus is disturbed, which leads to a disruption 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, cellulitis and trophic ulcers.In addition, inflammation and venous thrombosis may develop.
Symptoms include dilation, tortuosity of veins with 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 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 eliminate varicose veins.In recent years, phlebology (the science that treats veins) has changed a lot and today it is possible to get rid of varicose veins quite quickly and easily.There are several methods to get 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 firmly fixed thrombotic "seal" forms 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 ultrasonic control.This allows sclerosis of the 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 we are talking about taking a sclerotherapy course that consists of several sessions.
Today, sclerotherapy is used only to remove intradermal spider veins.When removing saphenous veins, the technique is used as a complement to other methods (EVLT, RFA, traditional operations) to remove venous ducts of small diameter.
Close veins with biological glue
A special medicine successfully closes the 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 polymeric "seal".After cessation of blood flow through the vein, as occurs with sclerotherapy, fibrous tissue forms 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 major veins and for the removal of smaller but deeply located veins, for example, perforators.
The procedure is performed under local anesthesia and lasts 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 clot of proteins and erythrocytes ("seal") in the lumen, which blocks the lumen of the vessel.
After cessation of blood flow, the lumen of the vein grows with fibrous tissue and then gradually resolves.
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 directed directly through the skin with a focused laser beam.This method removes only very fine intradermal vessels, less than 0.1 mm, located superficially (generally 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 the 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 frequency current (radio waves).
The RFA technique is effective, but has one major drawback: a considerable price (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The operation is shown:
- if the patient wishes;
- 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 earlier to remove a diseased vein it was necessary to make incisions along the entire leg, today it is enough to make two small incisions (sometimes one is enough) and remove a large vein with a special probe.
This not only preserves the beauty of the legs (it does not leave very visible scars), but also makes the operation itself less traumatic and the recovery period faster.
If the case is not very advanced, it is not even necessary to go to the hospital for surgery, but rather return home once the effect of 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 grabbed with special "hooks" that look like crochet needles and pulled out, where they are crossed and removed into fragments.
This procedure is performed under local anesthesia or general anesthesia.The disadvantages of the procedure are the intensity of the work, the impossibility of removing large and deep trunks and a high percentage of residual veins and their fragments.Today, this technique is used as a complement to EVLT, RFA or traditional surgery.
Both minimally invasive and traditional surgical methods give approximately the same results, which depend mainly on the degree of advanced disease.To achieve better treatment results, combinations of various 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 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.