Varicose Veins Treatment

Varicose Veins Treatment

What are varicose veins?

Varicose veins is an expansion of the veins in the legs or feet, which develops as a result of pathological changes in the walls of the venous vessels of the lower extremities and impaired venous blood flow. The veins are enlarged, dilated and congested with blood, and look swollen. They are blue or dark purple, and often have a lumpy, bulbous, or twisted appearance. 

When painful signs and symptoms appear, they include:

  • Feeling pain or heaviness in the legs.
  • Burning, throbbing, muscle spasms and swelling in the lower limbs.
  • Periodic convulsions.
  • Increased pain after prolonged sitting or standing.
  • Itching around one or more veins.
  • Discoloration of the skin around the varicose vein.
  • The appearance of spider veins.
  • Over time – a violation of tropism (dryness, ulcers)

Why are varicose veins dangerous?

In addition to pain, varicose veins have other dangers. 

Ulcers. Painful sores can form on the skin near varicose veins.

Bleeding. Sometimes veins close to the skin burst. This usually causes only minor bleeding, but still requires medical attention.

Blood clots. Due to the stagnation of blood in the vessels, blood clots are formed – dense blood clots. This can lead to conditions such as:  

  • thrombophlebitis  – swelling (inflammation) of the veins in the leg;
  • deep vein thrombosis, which can cause pain and swelling in the leg, as well as serious complications such as 
  • pulmonary embolism. This condition is very dangerous and can even lead to death.

Risk factors for developing varicose veins

  • Gender: Women are more likely to suffer from varicose veins than men. This is mainly due to the fact that female hormones relax the veins. 
  • Genetics: Varicose veins are often inherited.
  • Obesity: Being overweight or obese increases the risk of developing varicose veins.
  • Age: The risk increases with age due to wear and tear on the valves of the veins.
  • Some jobs: A person who has to stand for a long time at work has a higher risk of varicose veins.

Varicose Veins Treatment

But do not worry ahead of time. How to treat varicose veins in the legs in women and men, we will tell further.

Modern methods of Varicose Veins Treatment

Even in ancient Egypt, long before our era, people tried to figure out how to treat varicose veins of the lower extremities. Subsequently, the methods of treatment have changed dramatically and improved. Currently, surgeons have been able to learn not only to eliminate the altered inflows of veins in an operative way, but also to influence the very cause of the pathology and get rid of varicose veins without excess blood, pain and deep incisions. Modern methods of therapy for varicose veins are successfully applied at the outpatient level, using local anesthesia. Great importance is attached to the correct diagnosis of the disease. Phlebologists conduct a careful examination of the patient, use ultrasound examination of the veins, select and prescribe the optimal and effective treatment regimen. As a rule, the trends of modern medicine suggest that it is difficult to manage with only one method of treating varicose veins, especially in the later stages.

Currently, the vascular surgeon’s arsenal includes the following methods of treating varicose veins: conservative treatment of varicose veins, endovenous laser coagulation (EVLK), foam sclerotherapy, and surgical treatment.

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Conservative treatment of varicose veins

Conservative varicose veins treatment is prescribed when:

  • radical methods are contraindicated for the patient;
  • the patient refuses the operation (they are prescribed in the treatment regimen);
  • a woman is pregnant, breastfeeding;
  • there is chronic venous insufficiency and other systemic diseases;
  • in order to prevent recurrence of varicose veins after surgical treatment of varicose veins.

How to treat varicose veins conservatively:

  • lifestyle correction;
  • treatment with drugs that are prescribed orally and administered intravenously;
  • local treatment with ointments and gels;
  • the use of compression stockings;

Lifestyle Correction

  • Avoid prolonged standing or sitting – you need to exclude such loads on the legs.
  • Lose weight or maintain a healthy weight – overeating and being overweight negatively affects the course of venous pathology. 
  • Do exercises to improve circulation – bending movements in the ankle joint, lifting on tiptoe, rolling from toe to heel have a good effect.  
  • Perform breathing exercises – proper deep breathing stimulates venous blood flow.

Medical therapy

In case of varicose veins, drugs with venotonic and neuroprotective effects can be used. Inside are prescribed courses for 1-2 months several times during the year. The most popular are diosmin and its analogues: phlebodia, detralex, diosven, dioflan and others. 

Important: each drug has side effects, so only your doctor can prescribe them!

Local treatment

To alleviate the symptoms associated with venous insufficiency, local agents can be used:  troxevasin, heparin ointment, hepatrombin, venoruton, venitan and others. 

Topical products can cause skin itching, redness of the skin and rashes, so be sure to consult your doctor before using them.

Varicose Veins Treatment

The use of compression stockings

To reduce swelling, heaviness and a feeling of fullness in the legs, medical compression stockings (knee socks, stockings, tights) are used. Compression hosiery is assigned to each patient strictly individually. Elastic bandaging of the legs is used much less frequently. The advantages of compression stockings over bandages are obvious: 

  • simplicity and ease of putting on;
  • the ability to choose the optimal compression (pressure on the limb) depending on the type and severity of the disease;
  • medical participation is not required;
  • optimal conditions for maintaining the temperature and water balance of the legs;
  • high strength and sufficient durability.

How to choose compression stockings?

Compression stockings are divided into the following types:

Preventive. Recommended as a preventive measure for pregnant women or for those who, due to work or other reasons, sit or stand too much. 

Therapeutic. They are prescribed for the treatment of severe pathology.

Hospital. They are used to prevent thrombosis, for example during childbirth or surgery.

Antiulcer. They are prescribed for the treatment of trophic ulcers.

Endovenous laser coagulation (EVLK)

EVLT is the “Gold Standard” treatment for varicose veins, which is used throughout the world. The essence of this procedure is to glue the lumen of varicose veins by exposing their inner shell to laser irradiation. 

How to treat varicose veins in the legs with EVLK: a thin, flexible laser light guide is inserted into the vein through a small puncture. After that, an anesthetic solution is injected around the vein for pain relief. Strictly metered thermal energy is supplied through the light guide, which causes complete occlusion (“closure”) and further obliteration (“overgrowth”) of the pathologically altered vein. It is carried out under constant ultrasound control.

Coagulation has become widespread throughout the world due to the following advantages:

  • no incisions on the skin – the light guide is inserted into the vein through a small puncture;
  • coagulation is performed under local anesthesia in an outpatient setting;
  • immediately after the procedure, the patient can go home, because it does not require hospitalization;
  • there is no need to go for dressings and remove stitches.

EVLK is used both as an independent method for the treatment of varicose veins, and in combination with other methods of surgical treatment (mini phlebectomy, short stripping, etc.). 

As one of the alternatives to EVLT, radiofrequency ablation of veins is also often used in practice. The therapy takes place in the same way as coagulation, however, in this case, a different energy is used to influence the venous wall. Both methods offer quick recovery and good cosmetic results.

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Foam sclerotherapy

This method is used mainly in the early stages of varicose veins and consists in introducing a special medicinal substance into the lumen of the vein, which causes aseptic inflammation and gluing of the vessel wall. 

The method can be used in combination with laser coagulation or as an independent procedure when it comes to the expansion of small tributaries or the appearance of so-called spider veins.

The main advantage of sclerotherapy is the absence of skin incisions: all manipulations are performed through a skin puncture with a needle, under visual control and ultrasound. This ensures patient safety and optimal cosmetic results.

Other pluses include:

  • no need for hospitalization;
  • minimal trauma of the procedure;
  • absence of pain;
  • rapid healing of skin punctures without scars and scars.

Surgery

Surgical treatment of varicose veins requires hospitalization in a specialized hospital for vascular surgery. Interventions are performed using anesthesia – anesthesia or regional (spinal) anesthesia. Such operations include combined phlebectomy, endosurgical dissection of perforating veins.  Surgical treatment can lead to complications in the form of thrombophlebitis, damage to healthy tissues, nerves, and early recurrence of varicose veins.

What is dangerous advanced stage of varicose veins

People often turn a blind eye to varicose veins on the legs until there is already a very serious reason to go to the doctor. But, unfortunately, this disease does not go away on its own. Varicose veins progress rapidly. The longer you delay with the treatment of varicose veins on the legs, the worse the condition of the veins will be.

If you do not treat varicose veins, then in the future it is possible:

  • Bleeding from varicose vessels that rupture, unable to withstand the load.
  • Trophic ulcers are open wounds around which the skin changes color (darkens or turns pale). These wounds are difficult to treat, and doctors often diagnose them as recurrences.
  • Dermatitis is inflammation of the skin.
  • Eczema is a rash on the skin that is accompanied by itching and burning.
  • Thrombosis – blood clots appear on the walls of the affected veins, which come off and can lead to fatal consequences.
  • Thromboembolism is a condition where a blood clot enters a vein that feeds the lung. This can lead to the fact that the body simply fails. 
  • Acute thrombophlebitis, which can be fatal.

Contraindications in the treatment of varicose veins

Contraindications for Endovenous Laser Coagulation (EVLT)

  • inflammatory process in the area of ​​the planned intervention;
  • period of exacerbation of chronic diseases;
  • obesity;
  • pregnancy and lactation;
  • diseases of the vessels of the lower extremities;
  • violation of the function of walking in various pathologies of the musculoskeletal system, as well as after a stroke.

Contraindications to the treatment of veins with foam sclerotherapy:

  • infectious and dermatological diseases of the skin;
  • previously diagnosed heart defects in the patient;
  • individual allergic reaction to a sclerosing drug;
  • period of pregnancy or lactation;
  • thrombophlebitis.

Is it possible to cure varicose veins with a surgical method with concomitant diseases?

Contraindications for operations of varicose veins on the arms and legs are severe concomitant diseases of the cardiovascular system, lungs, liver and kidneys, excluding the possibility of performing any other operation. Surgical treatment is not indicated during pregnancy and in patients with purulent diseases of various origins.

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