With varicose veins, the veins lengthen and expand, and nodular deformations appear on them.At the same time, the functioning of the valvular 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 accompanied by disorders in the movement of blood to the heart, its stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers.Additionally, inflammation and venous thrombosis may develop.
Symptoms include dilation, tortuosity of veins with the formation of knots, varicosities or spider veins, intermittent and then permanent swelling, bronze color of the legs, inflammation of the skin and subcutaneous fat, 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 to eliminate 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 get rid of venous pathologies:
- Sclerotherapy.
- Application of organic glue.
- Laser coagulation.
- Radiofrequency ablation.
- Traditional operations.
- Miniphlebectomy.
Sclerotherapy
The essence of the technology lies in the fact that a special liquid preparation, a sclerosant, is injected into the diseased vein through a small puncture with a syringe.
A tightly held thrombotic “seal” forms in the vein, which stops blood flow through the vessel.As a result, the vein gradually dissolves.
The drug is administered both under visual and ultrasound control.This allows you to sclerotize invisible vessels on the surface and control the spread of the drug through the vessels.
To consolidate the effect after 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 they are talking about conducting a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is used only to eliminate intradermal spider veins.When removing saphenous veins, the technique is used in addition to other methods (EVLT, RFA, traditional operations) of removing small diameter venous channels.
Closing veins with biological glue
A special drug successfully closes 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, expels the blood and forms a polymer “seal”.After blood flow in the vein stops, as in the case of sclerotherapy, fibrous tissue forms and the vessel is partially resorbed.The materials required 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 ablation of large main veins and for the ablation 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 perforation and, with the help of light energy, coagulation (“folding”) of blood proteins is caused, forming a protein-erythrocyte coagulum (“seal”) in the lumen, which blocks the lumen of the vessel.
After blood flow stops, the lumen of the vein expands with fibrous tissue, and then it gradually reabsorbs.
The effect of the laser can be compared to the ablation 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 directly through the skin with a focused laser beam.This method only removes 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 of varicose veins is usually lower than the price of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Only large veins are removed by radiofrequency ablation.The method is basically similar to laser removal, however, with RFA the effect on the veins is not a laser, but a very high frequency current (radio wave).
The RFA technique is effective, but it has a big disadvantage: 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 certain anatomical features of the structure of large veins that prevent minimally invasive interventions (EVLT, RFA);
- with estial thrombosis of the 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 (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, you do not even need to go to the hospital for surgery, but return home once the anesthesia has worn 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 resemble hooks and pulled out, where they are crossed and removed into fragments.
This procedure is performed either under local anesthesia or general anesthesia.The disadvantages of the procedure are labor intensity, inability to remove deep and wide trunks and a high percentage of residual veins and their fragments.Today, this technique is used in addition to EVLT, RFA or traditional surgery.
Minimally invasive and traditional surgical methods give approximately the same results, which mainly depend on the degree of progression of the 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 based on the anatomical characteristics of varicose veins, the degree and severity of the disease, the presence of complications, general health, taking into account the personal needs and desires of the patient.