Treatment of varicose veins of the lower limbs: conservative and surgical techniques

Varicose veins is not only an aesthetic problem. It is a serious threat to the health and even lives. At the first sign of illness, it is necessary to consult a doctor and start the treatment.

Varicose veins

Let's try to understand what are the treatment methods can offer the medicine.

The modern approach to the treatment of varicose veins

Difficult to underestimate the prevalence of this pathology, in fact, according to statistics from it affects about 75% of women and 60% men. And this is only among the inhabitants of the developed countries. To explain the cause of varicose veins, it is necessary to have an idea of the structure of the veins of the lower limbs. The venous blood inside of our feet tirelessly moving upward, defying the laws of gravity, — for the implementation of this process in vienna are equipped with special valves that prevent the liquid to fall down between the shock of the heart. The malfunction of this mechanism causes a return current of venous blood, and because of the greater amount of the veins dilate, reducing their tone.

The first phase of varicose veins usually occurs without specific symptoms, accompanied by less significant discomfort in the area of the legs and the "weight" in the evening. You may notice that your legs will get tired even after short walks. The second sub-compensation, the phase of these signs have intensified, as they appear aching, pain, swelling, tingling in the legs, cramps.

The third, de compensation, a phase characterized by irreversible changes of the skin of the legs:

  • edema, which is completely not also go after sleep;
  • hyperpigmentation;
  • longer stiff — protruding seals the skin.

When the dermis becomes easily vulnerable, can be varicose veins eczema and, as the final of the alterations, trophic ulcer. Ignoring disease, the threat of these complications, such as thrombophlebitis and thrombosis.

Compared to before starting treatment, the more encouraging will be the prognosis. But after having achieved success, it is necessary to adapt the style of life, leaving the time for prevention procedures.

The suspicion of varicose veins should be the opportunity for a quick visit to a doctor, who will help you identify the disease and determine its stage.

The diagnosis is the first step toward healing

Varicose veins on the legs

First of all, an expert performs the polling of the patient is necessary for the collection of medical history. Follows standard inspection and palpation the direction of disease areas. For a more detailed and precise diagnosis apply duplex ultrasound, angio-scan with color mapping of blood flow. The procedure seems simple ULTRASOUND — the only difference is that, in addition to two-dimensional images the doctor sees the speed and the movement direction of the mapping of the flow of blood in the blood vessels. Modern ULTRASOUND devices allow you to define with precision the dead valves, the areas of pathological veins with the direction of movement of the blood, exactly label their projection on the skin.

After the diagnosis is finished, it is time to start taking measures to get rid of varicose veins.

The conservative treatment of varicose veins

With the help of methods of non-surgical, it is possible to prevent, hinder or facilitate the course of the disease. As the main way for the treatment of their use only in this case, if the operation is not possible.

Conservative methods include:

  • Compression therapy, that is, the use of a special underwear compression or elastic bandages. Their impact on the veins, thus facilitating the work of the valve and improving blood flow. The effectiveness of compression therapy demonstrated by many studies. There are no contraindications, such as atherosclerosis, aortoarteritis, inflammatory diseases of the skin and other.
  • The medical therapy involves use of drugs orally and for local use (in the form of ointments). To the groups of drugs for the treatment of varicose veins of the veins of the legs are venotonic and anti-inflammatory drugs, anticoagulants (blood thinners). The medicines the doctor prescribes individually. It is important to remember that everyone has contraindications. For example, most of the preformed venotonic can not be taken at the beginning of pregnancy and during breast-feeding. And during the intake of anticoagulants must be regularly take the exams for the clotting of the blood.

As the main treatment in the absence of possible obstacles and contraindications to prescribe one of the options of surgical treatment.

Traditional operation (venectomy)

Currently it is used only in specific cases, related to the special structure of the veins, or challenging the course of the disease, for example, for different forms of thrombophlebitis in acute.

Vienna on foot

The task is to dress up the place of the confluence of the trunk to the affected saphenous vein in the deep system (crossectomy) and subsequently by mechanical removal of the barrel itself. Manipulation performed under general anesthesia or with the use of spinal anesthesia and lasts for 1-2 hours. Due to the high frequency of post-operative complications — hematomas in places of removal of the trunk, along pain syndrome, neuralgia, and paraesthesia (numbness) — in recent traditional surgery leaves the place to the modern techniques. He refers to endo-venous laser coagulation.

After the surgery recommend regular physical activity, without substantial loads in the course of a month and a half, and is more suitable for compression therapy.

In addition to this treatment method, there are other, more "gentle" of ways to get rid of varicose veins on the legs.

Minimally invasive methods

There are different varieties of less traumatic methods of treatment of varicose veins. On the basis of the data of the patient and the characteristics of the disease, the doctor takes a decision on whether to perform one of the procedures.

Endo-venous laser coagulation

The operation of the endo-venous laser coagulation has become a method of treatment of varicose veins of any severity. Neither the manifestation of venous insufficiency, or thickness of the lumen venous trunk there are currently no limitations for endo-venous laser coagulation. This was possible thanks to the use of the following tools:

  • two laser wavelength with the absorption of a wave of hemoglobin, and the second vascular wall;
  • radial light guides, which includes the development of a circle of the whole internal surface of the vein;
  • automatic pump that allows pumping of a solution of anesthetic around vienna, providing relief from pain, the reduction of the diameter of the vein, protect the surrounding tissues.

Special training for endo-venous laser coagulation is not necessary. Before the intervention, necessarily takes place duplex ultrasonography. It is necessary for the performance of the standard blood pre-set analysis: in the municipality, biochemistry, coagulogram.

During the procedure, the doctor will puncture the affected vienna, after which introduces a thin (1 mm thick) catheter with a fiber optic. Throughout this process, and also the position of the light guide in vienna and the additional "beer" to vienna, controlled intraoperative ULTRASOUND machine. The operation lasts approximately 40 minutes and requires only local anesthesia.

Varicose veins on the legs

After the intervention of a hospital stay is not required, the patient must wear a compression garment for 3-5 days, and also for a couple of weeks recommend daily walks.

Radiofrequency ablation

The operation is essentially similar to laser coagulation. The only difference is that on the wall of vienna for his "closure" and subsequent resorption act radio radiation. Special preparation, in addition to the preoperative, is not necessary.

Currently, in connection with the improvement of laser systems with any advantage before the endo-venous laser coagulation, radiofrequency ablation has not. However, the procedure is more expensive because of a higher price waveguides.

The operation is not possible during pregnancy and lactation, in atherosclerosis of the arteries of the lower limbs and the inability to follow the motor activity.

Possible complications and a complex of remediation actions in a period of rehabilitation are similar to the previous procedure.

Mini-flebectomia

The principle of operation is to remove the tributaries and the nodes of vienna through bites or cuts on the skin with the aid of special tools. Is isolated veins varicose tributaries or as an additional procedure after the laser coagulation, radiofrequency ablation or surgical flebectomia.

The preparation is similar to the earlier procedures — standard set of analysis, but also an ultrasound of the veins. Contraindications — pregnancy and breast-feeding, acute infectious disease, thrombophlebitis, the violation of motor activity, the pathology of clotting of the blood.

The duration of the mini-flebectomia is 20-40 minutes, in a period of rehabilitation, it is necessary to wear compression stockings.

Sclerotherapy

Non-invasive technique in the treatment of varicose veins is suitable for varicose veins, and for aesthetic purposes — for the destruction of the vascular "stars" and "lattices".

Treatment of varicose veins

The contraindications to serve thrombophlebitis developed, the individual allergic reactions, infections, pregnancy and breastfeeding, the inability to perform injection accurately.

Sclerotherapy consists in the introduction into the vein through the puncture of a special substance that "paste" of the vessel wall, so that it is successful in its resorption. One of the most recent innovations — the technical foam-foam, which includes the use of foam in the form of medication. In this way, it is to a lesser extent, washed with the blood, which makes possible a decrease of the concentration and amount of substance, with an increase of efficiency. The operation is done without anesthesia, as well as for puncture requires only a thin insulin needle.

Side effects of sclerotherapy may be attributed to the pigmentation, which appears to be moving sklerozirovanie of vienna. In some cases, it may be incomplete bonding of vienna, which requires the execution of repeated treatments.

After sclerotherapy, it is necessary to wear a compression garment, and avoid physical exertion and high temperatures (for example, when you visit the sauna).

Price sclerotherapy depends on the execution volume. For the removal of large veins trunks sclerotherapy now is almost never used. And the session of sclerotherapy in the small nodes or venous mesh will cost 7000 up to 20 000 rubles.


With the development of medicine to fight varicose veins on the legs is passed from the category of the "Hundred years war" in the category of "quick wins". Sophisticated surgical techniques have given way to minimally invasive procedures, a more secure and productive. Today varicose veins — is not a sentence, but only a reason to see a specialist.