In the case of varicose veins, the veins are elongated, dilated, and nodular deformities appear on them.At the same time, the operation of the valve apparatus is disrupted, which leads to disruption of blood flow in the affected vein.
Varicose veins not only lead to a pronounced aesthetic defect, but can also be associated with disturbances in blood flow to the heart, stagnation in organs, skin inflammation, eczema, cellulite and trophic ulcers.In addition, inflammation and venous thrombosis may develop.
Symptoms include dilation, tortuosity of the veins with the formation of nodes, spider veins or spider veins, periodic and then persistent swelling, bronze color of the legs, inflammation of the skin and subcutaneous fat, and the development of trophic ulcers.
Fortunately, there are now ways to treat varicose veins that do not require surgery.
Modern treatment without surgery
The essence of each procedure is the removal of the varicose vein.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 get rid of pathologies of veins:
- Sclerotherapy.
- Application of biological glue.
- Laser coagulation.
- Radiofrequency ablation.
- Conventional operations.
- Miniphlebectomy.
Sclerotherapy
The essence of the technology is that a special liquid preparation, a sclerosant, is injected into the patient's vein with a syringe.
A tightly fixed thrombotic "seal" is formed in the vein, which stops the blood flow in the vessel.As a result, the vein gradually dissolves.
The drug is administered under visual and ultrasound control.This allows for the sclerosis of blood vessels that are not visible on the surface and controls the spread of the drug through the blood vessels.
In order to consolidate the effect, after the administration of the sclerosant, the patient is recommended to wear compression stockings for several weeks or even months.Repeated administration of the sclerosant is often necessary;in this case, they are talking about completing a sclerotherapy course consisting of several sessions.
Today, sclerotherapy is only used to remove intradermal spider veins.When removing saphenous veins, the technique is used as a supplement to other methods (EVLT, RFA, conventional surgery) to remove small-diameter venous channels.
Closure of blood vessels with biological glue
A special drug successfully closes the veins at different stages of varicose veins.The procedure is similar to the previous one, but in this case, an adhesive is introduced into the lumen, which polymerizes upon contact with the blood, pushes the blood out and forms a polymer "seal".After the blood flow through the vein is stopped, as during sclerotherapy, fibrous tissue forms and the vein is partially resorbed.The materials required for the 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 to remove both large main veins and smaller but deep veins such as perforators.
The procedure is performed under local anesthesia and lasts from 20 minutes to an hour.With a small puncture, a laser light guide is inserted into the vein, and with the help of light energy, the coagulation of blood proteins ("folding") is induced, which forms a protein-erythrocyte coagulation ("seal") in the lumen, which closes the lumen of the vessel.
After the blood flow ceases, the lumen of the vein grows with fibrous tissue and then gradually dissolves.
The effect of the laser is comparable to the removal of 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 with a focused laser beam directly through the skin.This method removes only very thin, less than 0.1 mm, superficial intradermal blood vessels (usually capillaries, venules, or arterioles).The disadvantages of this method are frequent relapses and burns.
Otherwise, the cost of laser treatment of varicose veins is usually lower than the price of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Only large veins are removed with radiofrequency ablation.The method is basically similar to laser removal, however, with RFA, the veins are not affected by a laser, but by a very high frequency (radio wave) current.
The RFA technique is effective, but has one big drawback - a significant price (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The action can be seen:
- if the patient wishes;
- in the presence of certain anatomical features of the structure of large veins, which prevent minimally invasive interventions (EVLT, RFA);
- with estial thrombosis of large venous trunks.
Fortunately, the way we treat varicose veins (phlebectomy) has also changed today.
If previously it was necessary to make incisions along the entire length of the leg to remove the diseased vein, 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 (doesn't leave very noticeable scars), but also makes the surgery itself less traumatic and speeds up the recovery period.
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 on small punctures of the skin (up to 1-2, rarely up to 3 mm), the vessels are grabbed with special "hooks" that look like crochet needles and pulled out, where they are crossed and removed in pieces.
This procedure is performed under local anesthesia or general anesthesia.The disadvantages of the procedure are labor intensity, the inability to remove deep and large trunks, and a high percentage of remaining veins and their fragments.Today, this technique is used as an adjunct to EVLT, RFA, or conventional surgery.
Both minimally invasive and traditional surgical methods give approximately the same result, which primarily depends on the progress of the disease.To achieve better treatment results, a combination of several methods are used, such as EVLT and sclerotherapy or miniphlebectomy, RFA and sclerotherapy, surgery and miniphlebectomy, etc.
Only an experienced doctor can choose the treatment 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 patient's personal needs and wishes.