In the case of varicose veins, the veins are elongated and widened, nodular deformations appear on them.At the same time, the functioning of the valve apparatus is impaired, which leads to disruption of the 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, stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and venous thrombosis can develop.
Symptoms include dilatation, distortion of veins with the formation of nodules, cobwebs or cobwebs, periodic and then permanent swelling, bronze color of the legs, inflammation of the skin and subcutaneous fatty tissue, 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 the removal of 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 vein pathology:
- 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" 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 ultrasound control.This allows you to sclerose superficially invisible vessels and control the spread of the drug through the vessels.
To consolidate the effect after applying the sclerosant, the patient is recommended to wear compression stockings for several weeks or even months.Repeat application of sclerosant is often required;in this case, they are talking about conducting a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is only used to remove intradermal spider webs.When removing saphenous veins, the technique is used as a supplement to other methods (EVLT, RFA, traditional operations) to remove venous channels of small diameter.
Closure of 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, squeezes the blood and forms a polymer "seal".After stopping the blood flow through the vein, as in sclerotherapy, fibrous tissue forms and the vessel is partially resorbed.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 major veins and to remove smaller but deep veins such as perforators.
The procedure is performed with local anesthesia and takes from 20 minutes to an hour.Through a small puncture, a laser light guide is inserted into the vein and with the help of light energy, coagulation ("folding") of blood proteins is induced, forming a protein-erythrocyte coagulum ("seal") in the lumen, which blocks the lumen of the vessel.
After stopping the blood flow, the lumen of the vein grows with fibrous tissue, after which it gradually dissolves.
The effect of the laser can be compared to removing a vein.The patient can go home immediately after the operation 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, superficial 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 of varicose veins is usually lower than the cost of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Radiofrequency ablation only removes large veins.The method is fundamentally similar to laser removal, but 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 has a major drawback - significant cost (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The operation is shown:
- at the request of the patient;
- in the presence of some anatomical characteristics of the structure of the 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 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 (it 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 do not even need 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 caught with special "hooks" that look like crochet hooks and are pulled out, where they are crossed and removed in fragments.
This procedure is performed under local anesthesia or general anesthesia.The disadvantages of the procedure are labor-intensiveness, the impossibility of removing deep and large trunks and a high percentage of residual 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 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 choose a therapeutic 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 wishes of the patient.