Varicose veins of the legs are a disease of the saphenous vein, in which the saphenous vein is pathologically dilated.Varicose veins are swollen veins that usually occur in the legs.Women are more likely to develop varicose veins than men.For a long time, varicose veins were just a cosmetic problem (spider veins), but if varicose veins are left untreated, they can worsen and may lead to complications over time.70% of patients with varicose veins will develop major complications - trophic ulcers, thrombophlebitis, untreated skin color changes.
Symptoms of varicose veins
- swollen and enlarged veins in the legs
- Heaviness in the legs and fatigue at night
- Swelling of feet after exercising at night
- Changes in skin color of calves
- Inflammation of the saphenous vein - thrombophlebitis
- cutaneous trophic ulcer
Varicose veins causes and risk factors
- Composite genetic-congenital malfunction of the valve device
- Heavy physical labor while standing
- frequent pregnancies and births
- walking in high heels
Our clinic's modern approach to treating varicose veins of the lower extremities can resolve this problem without the need for serious surgical intervention, pain, incisions and hospitalization.
Modern phlebology allows patients to treat varicose veins painlessly, very aesthetically and reliably.The first sign of varicose veins should be reason to contact a phlebologist.Varicose veins of the lower limbs mean a complete loss of tension in the vein walls, therefore, it is useless to influence the transformation of varicose veins with tablets and leeches.
diagnosis
Complaints and Symptoms
Varicose veins begin with the appearance of a single nodule of dilated veins and progress steadily.Varicose veins may not cause any problems at first, but over time they can become a risk factor for serious health risks.So, let’s take a look at the main concerns that patients with varicose veins have:
cosmetic discomfort
Most patients with varicose veins complain only of unsightly nodes of varicose veins that ruin the appearance of their legs.Varicose veins in women are particularly likely to cause this symptom.Many times, cosmetic discomfort is caused by small varicose and spider veins, which do not threaten health but force you to close your legs.Such patients require treatment for cosmetic reasons, so only minimally invasive (no incisions) methods are recommended for them.
chronic venous insufficiency
About 30% of patients with varicose veins complain of leg heaviness, nighttime swelling, and nighttime calf cramps.These are signs of chronic venous insufficiency.Gradually, the symptoms worsen and the varicose nodules may become painful.Skin changes and pigmentation appear.If venous insufficiency is severe, the skin on the lower third of the leg may be damaged, forming trophic ulcers that are difficult to treat.Often, patients with advanced varicose veins develop skin inflammation - eczema.
Checked by a phlebologist
If varicose veins cause you any discomfort, you need to consult a phlebologist.The examination was performed in the lying and standing positions.The patient must fully open the legs.
Varicose veins are diagnosed during a routine exam, which is done while standing while the veins are full.After the examination, an ultrasound duplex scan is always required.Often, such a diagnosis is sufficient.However, if secondary varicose veins are suspected, the deep venous system needs to be examined.
Vein ultrasound scan
In the case of varicose veins, the task of venous ultrasound is to identify insufficiency of the venous trunks, identify non-functioning venous valves and identify thrombi in the superficial and deep venous systems.
The examination begins by examining the saphenous vein while standing.Study the diameter and patency of the great and small saphenous veins, determine the consistency of the valves (Valsalva maneuver - tension of the abdominal muscles during full inspiration, a sign of insufficiency is reflux of blood).Typical locations of perforating veins and their motility during the Valsalva maneuver are then studied.
After assessing the superficial veins, it is necessary to assess the patency of the deep veins.To do this, examine the popliteal and femoral veins while lying down, assessing their patency and valve consistency.
venography
Usually, ultrasound scanning is sufficient for the complete diagnosis of venous pathology, but in some cases it is necessary to study the relationship between the state of the deep and superficial venous system, especially in the case of varicose veins and secondary varicose vein recurrence.
In order to solve these problems, X-ray imaging examination is used.The saphenous vein is punctured and contrast medium is injected.Observe the movement of the contrast on the monitor of the X-ray machine and perform all necessary tests and projections.Currently, venography is rarely used for varicose veins.
treat
The "classic" varicose vein surgery under anesthesia, in which incisions were made in the groin area and legs, used at the turn of the last century to remove superficial varicose veins, has become a throwback to the past.The pain, long hospital stay, and leg pain this surgery meant to improve blood flow causes to the patient is completely unjustified.Severe varicose veins can be treated without resorting to the "asking method."Today, treatment of advanced varicose veins can be performed without anesthesia and hospitalization.The work of a phlebologist is office-based and does not have the characteristics of a major surgery.
Understanding what causes varicose veins in the legs allows us to develop the hemodynamic principles of treatment.Their implementation can be achieved by removing or closing veins in the blood circulation.Modern technology is based on the principle of fusion of vein walls in areas with insufficient venous valves.The methods of affecting the venous circulation may differ, but their goal is the same - to prevent the pathological drainage of blood through the affected veins (anti-reflux).
How to treat varicose veins in the legs?
Understanding the cause of varicose veins allows you to choose the right treatment.The goal of modern treatment of varicose veins is to solve several problems:
- Pathological discharges are terminated in a vertical position through the incompetent saphenous vein of the lower limb.
- Elimination of reflux between deep and superficial veins - perforators - is the main mechanism in the development of trophic ulcers in varicose veins.
- Removal of varicose veins - superficial blood vessels that have degenerated (varicose veins).
- Compression therapy is performed using special stockings and socks.
function of vascular center
Thermal methods for treating varicose veins are endovenous laser coagulation (EVLC) and radiofrequency ablation (RFO) of lower extremity veins.
Intravenous laser coagulation is an effective method for treating varicose veins and is based on the thermal effect of laser energy.This treatment was introduced in 2001 and is still the best.With laser coagulation, damaged veins are heated by a laser beam, which produces a strong effect that destroys the collagen of the vein wall, causing an inflammatory process in the veins and their overgrowth.Advanced varicose veins in the legs treated with this method completely subside, leaving no traces, and their main symptoms disappear: swelling, heaviness in the legs, hyperpigmentation of the skin.
EVLT begins by installing a laser fiber into the lumen of the varicose vessel through a skin puncture and guiding it along the affected vein to the site of the incompetent valve.For patients, this method is a safe, painless and reliable way to prevent the further progression of the disease and its complications.When the EVLT method is used correctly, varicose veins can be completely eliminated in 98% of patients.The functionality of this method makes it possible to treat varicose veins in the legs of women and correct the venous outflow of trophic ulcers.
Radiofrequency ablation (RFO)
The treatment of varicose veins using radiofrequency ablation (RFO) is a similar thermal method, but due to the radio wave energy, the heating of the vein wall tissue occurs according to different physical principles.Radiofrequency ablation can eliminate varicose veins and eliminate their symptoms; the short-term and long-term results of this treatment are no different than EVLT, but it is more laborious for the phlebologist.
Other thermal methods
When deciding how to treat varicose veins, phlebologists often use exotic methods.Varicose veins are treated using the thermal effects of superheated steam and bipolar electrocoagulation.However, modern thermal methods are more effective and allow doctors to prevent the further development of varicose veins and can be treated on an outpatient basis without affecting the patient's lifestyle.In the hands of a novice phlebologist, thermal ablation methods can lead to unpleasant complications: loss of sensitivity, burns, seals.This method is more than 98% effective in the hands of an experienced phlebologist. The laser method and RFO can not only eliminate the initial form of varicose veins in the legs, but also eliminate severe varicose veins in the legs without the need for incisions.In the photos in the Treatment Results section you can see before and after views of the minimally invasive treatment.
Non-Thermal Methods to Eliminate Stem Backflow
For years, phlebologists have wondered how to heal varicose veins in the lower extremities without causing incision and pain.The disappearance of the saphenous vein in the arm after frequent injections gave rise to the idea that certain substances may cause inflammation of the vein wall - thrombophlebitis and its subsequent combination with the disappearance of the venous lumen.The development of nonthermosclerotic obliteration began after the advent of the Fegan method, when treatment began to depend on the cause of varicose veins.Since then, varicose veins in the legs, especially in women, can be treated not only with a scalpel, but also with a syringe.
Sclerotherapy
Sclerotherapy appeared in physician practice at the end of the 19th century.In recent years, methods of treating varicose veins by injecting special substances (sclerosants) have become increasingly sophisticated.The point of sclerotherapy is to inject drugs into the varicose veins, causing inflammation and subsequent adhesion of the varicose veins.Sclerotherapy does not involve eliminating the cause of venous insufficiency and is more suitable for certain forms of varicose veins or the initial stages of the disease.Advanced varicose veins of the lower limbs require a more complex approach to treatment; long-term effects of sclerotherapy cannot be expected for injuries to the trunk of the great saphenous vein or the trunk of the small saphenous vein, since recurrence due to reflux is certain.
Sclerotherapy can be performed without allergy to myristyl sulfate or polidocanol.These substances are the primary hardeners.During sclerotherapy, manifestations of thrombophlebitis may occur, especially when liquid forms of the drug are used.Sclerotherapy of perforated veins is very effective in treating venotrophic ulcers.Symptoms of varicose veins of the lower limbs at any stage can be eliminated with the help of sclerotherapy, but the recurrence rate in the next 5 years is approximately 40%.
The advantages of sclerotherapy are immediate results and low treatment costs.Injection of sclerotherapy causes the veins to coalesce and stops the pathological process - the return of blood through the saphenous vein.This medication is usually injected as a foam into varicose veins.Formation of dilated subcutaneous vasospasm, prolonged contact of sclerosing agents in the form of foam with the venous wall and subsequent inflammation and adhesions.This process occurs unevenly, and the degree of venous occlusion varies, so varicose veins will return in 40% of patients after sclerotherapy.After sclerotherapy, the affected areas of the veins of the lower limbs are closed, heal completely over time, and blood flow in the opposite direction ceases.In order to prevent skin necrosis due to penetration of the sclerosing agent in foam form into the subcutaneous tissue, the administration was strictly under ultrasound control.
Foam sclerotherapy can be used alone or in conjunction with laser treatment to eliminate varicose veins.The number of sessions with sclerotherapy to eliminate varicose veins depends on the stage of the varicose veins and the condition of the veins.The treatment course usually includes 2-3 surgeries.The area of skin over the hardened blood vessels may appear dark (hyperpigmentation) for 2-3 months.It can damage a woman's legs for several months, so this treatment is best done during the winter.Medication and ultrasound-guided vascular puncture can accelerate the resorption process of intravascular fluid (clot), with a risk of approximately 10%.Condensation can form when there is insufficient compression, but will definitely disappear over time.Many patients know that within a month of sclerotherapy, symptoms of varicose veins in the lower extremities disappear for years, which is why sclerotherapy remains one of the most popular treatments.
Use special glue
Since its introduction, this method has aroused great interest among phlebologists.It involves gluing the main trunk of the great saphenous vein with a special cyanoacrylate glue.In the lumen of the blood vessel, this glue aggregates and fills the lumen of the dilated blood vessel.According to the developers, this method does not require any anesthesia, and a "plug" appears in the blood vessel, reliably blocking the blood flow.With this in mind, half an hour of surgery to eliminate varicose veins in the legs is enough.Venasil is the only technology for treating varicose veins that does not require wearing compression stockings.
Most women can resume normal activities immediately.Symptoms of chronic venous insufficiency resolve soon after surgery.The process of actively promoting this glue to the intravenous market should begin in the near future.But there are also certain disadvantages: the presence of foreign matter in the human body.The clotted glue remains in the container forever and can cause chronic allergies; sometimes the blood vessel walls become inflamed or the polymer rejects and suppurates.Acute thrombophlebitis may occur in adherent blood vessels.
The use of glue in the great saphenous trunk does not eliminate the need to eliminate varicose tributaries, which is why doctors must eliminate signs of subcutaneous varicose veins through sclerotherapy or venectomy.The visible effects of using glue appear only when combined with other methods of eliminating varicose veins.Patients must pay more.The cost of the bonding kit is prohibitive, making the process much more expensive than modern laser or radio frequency methods.
In our clinic, priority is given to thermal methods.We believe it is better to have a good local anesthesia rather than use expensive and untested methods to treat saphenous varicose veins in the legs.And, the results are the same at best.If it recurs, patients will have to undergo complex surgery to remove the sealed blood vessels because other methods will no longer work.
Mechanochemical elimination technology
Modern approaches to the comprehensive treatment of reflux along the subcutaneous venous trunks add additional weight to traditional sclerotherapy.Mechanochemical surgery implies a combination of mechanical damage to the inner surface of the vein wall and the introduction of sclerosing drugs.The catheter was inserted into the main saphenous vein via puncture under ultrasound guidance.Once the conduit is installed in the desired location, the equipment can be connected.The sharp head of the catheter rotates at up to 3,500 rpm, causing severe damage to the lining of the vein wall.At the same time, sclerosing drugs are injected through the catheter, which are "mixed" in the blood vessel cavity and use the rotating part of the catheter to act on the blood vessel wall, causing inflammation and adhesion.
The only advantage of this technique so far is that it does not require tumescent anesthesia.According to its inventors, mechanochemical elimination should induce stronger elimination effects than foam sclerotherapy, although for some reason convincing data has not yet been provided.Obviously, such varicose veins can be treated by other minimally invasive methods, so the advantages are not obvious.We will have to wait for further studies in Europe or the United States to accurately determine the status of this technology.
venous resection
This is a modern cosmetic microsurgery method for removing varicose veins.It involves the delicate technique of puncturing and extracting varicose veins using special tools.This surgery is not suitable for novice phlebologists; you will need fine surgical skills.A phlebectomy is a surgery performed without the use of a scalpel and under local anesthesia.The piercings are performed in the direction of the skin's lines, so they are virtually invisible after two months.
Phlebectomy has replaced traditional varicose vein surgery, which requires the use of a 1-3 cm incision, because it is aesthetically pleasing, painless and highly effective.By assuming the presentation of varicose veins, the physician can clearly plan the micropuncture and complete it with minimal intervention.Patients can go home on their own immediately after surgery.Phlebectomy can be used as an independent and effective method to treat varicose veins, or it can be used in combination with laser coagulation of varicose veins.The removal of varicose veins is performed using a special technique developed by Professor Varady.Our phlebologists have perfected this technique to remove varicose veins in the legs - an effective treatment regardless of their cause.
treatment results
Varicose vein treatment results
The effectiveness of modern treatments for varicose veins can be said to be very good.Any technique, if performed correctly, can eliminate the symptoms of varicose veins in the legs.Almost 95% of patients remain varicose vein-free for 5 years or more, and 80% of these patients never develop severe venous outflow problems.The innovative Vascular Center is ready to help you manage any venous condition without incisions or pain.We know how to treat varicose veins and have extensive experience.In the modern high-tech world, treatment of varicose veins should not be a problem.