With varicose veins, the veins are elongated and widened and nodular deformations appear on them.At the same time, the operation of the valve apparatus is interrupted, which leads to the cessation of blood flow in the affected vein.
Varicose veins not only lead to a significant cosmetic defect, but can also be associated with disturbances in the movement of blood in the heart, its stagnation in the organs, dermatitis, eczema, cellulite and trophic ulcers.In addition, inflammation and thrombosis of veins can develop.
Symptoms include dilation, twisting of veins with the formation of nodules, spider veins 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 surgical intervention.
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 ways to get rid of vein pathologies:
- Sclerotherapy.
- Application of biological adhesive.
- 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 the flow of blood 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 invisible vessels on the surface and control the spread of the drug through the vessels.
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 required;in this case, they talk about performing a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is used only to remove intradermal spider veins.During the removal of the saphenous veins, the technique is used in addition to other methods (EVLT, RFA, traditional operations) for the removal of venous channels of small diameter.
Sealing the veins 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 substance is introduced into the lumen, which, after contact with blood, polymerizes, squeezes the blood and forms a polymer "seal".After stopping the blood flow through the vein, as with 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/ablation or endovenous laser therapy (EVLK, EVLA, EVLO, EVLT) is used both to remove large major veins and to remove smaller but deeply located veins, for example, perforators.
The procedure is performed with local anesthesia and lasts from 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 protein-erythrocyte coagulum ("seal") in the lumen, which blocks the lumen of the vessel.
After the cessation of blood circulation, the lumen of the vein grows with fibrous tissue, then gradually dissolves.
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 targeted directly through the skin with a focused laser beam.This method removes only very thin intradermal vessels, less than 0.1 mm, located superficially (usually 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 previous methods.
Radiofrequency ablation/ablation (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 wave).
The RFA technique is effective, but has a major disadvantage - a significant price (due to the high cost of equipment and consumables).
Surgical treatment – phlebectomy
The operation is indicated:
- according to the patient's 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, today the way we perform the operation for the treatment of varicose veins (phlebectomy) has also changed.
If before, 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 visible marks), but also makes the operation itself less traumatic and the recovery period faster.
If the case is not too advanced, you don't even have 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, rarely 3 mm), the veins are captured with special "hooks" that look like a hook and are pulled, where they are crossed and removed in fragments.
This procedure is performed either under local anesthesia or general anesthesia.The disadvantages of the procedure are the labor intensity, the impossibility of removing deep and large trunks and a high percentage of remaining veins and their fragments.Today this technique is used in addition 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 disease progression.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 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.