With varicose veins, the veins are elongated and dilated, and nodular deformations appear in them.At the same time, the function of the valve apparatus is disturbed, which causes a violation of blood flow in the affected vessel.
Varicose veins are not only an obvious cosmetic defect, but can also be accompanied by disturbances in blood flow to the heart, stagnation in organs, dermatitis, eczema, cellulitis and trophic ulcers.In addition, inflammation and vascular thrombosis may develop.
Symptoms include enlargement, tortuosity of the 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 surgery.
Modern treatment without surgery
The essence of all procedures is to eliminate varicose veins.Phlebology (the science of treating veins) has changed a lot in recent years, and today you can get rid of varicose veins quite quickly and easily.There are several ways to get rid of vascular pathologies:
- Sclerotherapy.
- Application of biological glue.
- Laser coagulation.
- Radiofrequency ablation.
- Traditional operations.
- Miniphlebectomy.
Sclerotherapy
The essence of the technology is that sclerosant, a special liquid preparation, is injected into the patient's vein through a small puncture with a syringe.
A tightly fixed thrombotic "seal" is formed in the vein, which stops blood flow in the vein.As a result, the vein gradually dissolves.
The drug is administered both under visual control and under ultrasound control.This allows sclerosing vessels that are not visible on the surface and controlling the distribution of the drug through the vessels.
After applying the sclerosant, the patient is advised to wear compression stockings for several weeks or even months to enhance the effect.Repeated application of the sclerosant is often required;in this case, they are talking about conducting a course of sclerotherapy consisting of several sessions.
Today, sclerotherapy is used only to remove intradermal spider veins.When removing saphenous veins, the technique is used in addition to other methods (EVLT, RFA, traditional operations) for removing small-diameter venous channels.
Binding 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, when in contact with blood, an adhesive substance is introduced, which polymerizes, compresses the blood and forms a polymer "seal".After the blood flow through the vein is stopped, as in sclerotherapy, fibrous tissue forms and the vein 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 to ablate both large major veins and small but deep veins such as perforators.
The procedure is performed under 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 occurs, forming a protein-erythrocyte coagulum ("seal") in the lumen, which closes the lumen of the vessel.
After the cessation of blood flow, the lumen of the vessel 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 technique 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 for varicose veins is generally lower than the cost of previous methods.
Radiofrequency ablation/obliteration (RFA, RFO)
Only large vessels are removed with radiofrequency ablation.The method is similar in principle 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 it has a major drawback - significant cost (due to the high cost of equipment and consumables).
Surgical treatment - phlebectomy
The transaction is displayed:
- at the request of the patient;
- in the presence of some anatomical features of the structure of large vessels that interfere with 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 it was necessary to make incisions along the entire length of the leg to remove a diseased vein, 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 noticeable scars), but also makes the operation itself less traumatic and the recovery time faster.
If the condition is not very advanced, you don't even need to go to the hospital for surgery, but go home after the anesthesia is over.
Miniphlebectomy
It consists in capturing the vessels through small punctures of the skin (up to 1-2, less than 3 mm) with special "hooks" similar to knitting hooks and removing them, cutting them and removing them with fragments.
This procedure is performed under local anesthesia or general anesthesia.Disadvantages of the procedure are labor intensity, inability to remove deep and large trunks, and high percentage of residual vessels 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 depends on the degree of advanced disease.To achieve better treatment results, a combination of several methods is 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 characteristics 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.