Conservative treatment methods are effective only in the initial stages of varicose veins.And since the first signs usually go unnoticed, the pathology continues to develop, reducing the effectiveness of the drugs used.If symptoms worsen significantly, the only option to remove varicose veins is surgery.A special place is occupied by rehabilitation, which requires patients to comply with medical recommendations.
Indications for surgery
If there are varicose veins, in certain cases surgical treatment is prescribed.
In particular, surgical intervention is indicated for patients with:
- extensive vascular damage, which can be determined by visual examination;
- symptoms in the form of swelling, constant pain and a feeling of heaviness;
- significant risk of thrombophlebitis, trophic ulcers.
Varicose vein surgery is appropriate when the use of medications does not produce the desired results.It is important to prevent the disease from developing to the point where surgical treatment is useless.
For some patients, leg varicose vein surgery may be contraindicated.
Contraindications
Late-stage surgery is often inappropriate;Consequently, varicose veins are treated with various drugs.They help to slightly reduce the severity of the disease, but cannot eliminate it completely.
Patients suffering from:
- inflammatory skin diseases at the site of development of venous pathology (for example, erysipelas or eczema);
- cardiovascular disorders (coronary artery disease, hypertension, heart failure);
- acute form of phlebitis;
- infectious diseases (surgery is possible after recovery);
- venous thrombosis, pulmonary embolism (history);
- Obliterating atherosclerosis of the vessels of the lower extremities.
Surgical treatment to eliminate varicose veins is contraindicated in patients over 70 years of age, as well as in pregnant women.
Preparing for surgery
A consultation with a phlebologist will help you properly prepare for the upcoming surgical treatment.The patient has the right to raise any questions that interest him or her regarding the operation.
You should also describe the symptoms present as accurately as possible, talk about a possible intolerance to certain medications, and be sure to disclose any medications you are currently taking.
The treating doctor refers the patient to a series of diagnostic procedures:
- blood and urine tests;
- fluorography;
- electrocardiograph;
- duplex ultrasound.
The preparatory stage requires compliance with certain conditions:
- 3 days before surgery, the patient must follow a slag-free diet, that is, fried, salty, spicy, as well as meat and floury products are prohibited.
- The last food and liquid intake is 8 hours before surgery.
- For at least 3 days you should forget about alcohol and tobacco.
- It will be necessary to remove hair from the leg where the operation will be performed and use a razor.
- If there are ulcers, bruises or any damage to the skin, you should inform your doctor.
If the patient drives a car, they should arrange for someone close or family to pick them up after discharge.Driving is currently prohibited.
When preparing for surgery, the patient is interested in knowing what type of surgical intervention is indicated and how much said treatment costs.If a patient is scheduled for vein surgery, the price is influenced by many factors: the stage of the disease, the length of the vessel affected by varicose veins, anesthesia, etc.
Methods to eliminate varicose veins.
Since there are many types of surgical treatment for varicose veins, the choice of a specific technique is made based on diagnostic data.In some cases, the venous vessel is completely or partially removed, in others, deformed veins due to varicose veins are sealed or narrowed with a special substance.
Phlebectomy
A type of surgical treatment during which areas of blood vessels where varicose veins are present are removed.After extraction, blood movement will be through deep veins.
The operation is carried out as follows:
- Once the anesthesia has taken effect, the surgeon makes small incisions (up to 5 mm).
- The vein is removed with a special probe, after which the affected area is resected.
The duration of phlebectomy is 1 to 2 hours.Afterwards, a small scar remains at the operated site.
Microphlebectomy
An excellent alternative to the previous method.The essence of the technique is that it is not necessary to make 5 mm incisions.A small puncture is enough to perform all the necessary manipulations with the vein.In addition, the recovery in this case is much faster and there are no scars.
All types of operations performed to eliminate varicose veins in the legs turn out well and cause complications in very rare cases.
Thanks to this puncture technique it is possible to eliminate even the largest varicose veins.
stripping
It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon removes the vessel affected by varicose veins through a small incision, using a special probe.Incisions are made in the area of the inguinal fold and the ankle on the inside.
Disassembly occurs:
- partial– only part of the venous vessel is removed;
- total– the diseased vein is stretched together with its small branches.
Carrying out such manipulations requires maximum care from the doctor.If at least one tributary remains uncrossed, the risk of relapse increases significantly.
Sclerotherapy
This is a surgery to eliminate progressive varicose veins, which is minimally invasive and does not require incisions.The surgeon's actions are aimed at narrowing the lumen of the diseased vessel until its complete disappearance.
To do this, a sclerosant is injected into a vein.The drug promotes irreversible damage to the walls of the vessel, followed by excessive growth of the lumen.
Medications specially designed for this purpose are generally used.
Sclerotherapy has several advantages:
- The procedure can be performed on an outpatient basis;
- the patient is allowed to return to daily activities the next day;
- there is no need for general anesthesia;
- There are no scars left after the operation.
A negative point is the likelihood of varicose veins forming again.The disease can affect veins located next to those where the sclerosant was injected.In one procedure, up to 10 injections are performed and the treatment duration is approximately one hour.
It should be said about the types of sclerotherapy:
- Foam.The drug used, in contact with air, forms foam that fills the cavity of the glass.Closure of the lumen occurs in a short period of time and even a small amount of sclerosant is sufficient.In addition, to obtain satisfactory results, 1-2 procedures are performed, during which the foam is injected a maximum of 3 times.
- Microsclerotherapy.The technique is appropriate in the initial stages of the disease.
- Echosclerosis.Prescribed for deep vein injuries.The injection is carried out using an ultrasound scanner, which makes it possible to clearly distinguish the injection site of the sclerosant, accurately determine the amount of medication and avoid undesirable consequences.
The manipulations performed are practically painless and subsequently patients recover quickly.
Laser coagulation
This method of treating varicose veins, called endovenous (endovasal) laser coagulation (obliteration), involves the use of a special device - an LED laser.
It is injected into the affected vein and, thanks to its radiation, the internal surfaces of the vessel are welded.Blood continues to circulate through healthy veins and the patient's well-being improves.
Advantages of laser coagulation:
- absence of scars and age spots on the skin;
- performed on an outpatient basis for 1-2 hours;
- local anesthesia is used;
- manipulations are carried out under the control of an ultrasound machine;
- short recovery period.
The success of the operation can finally be judged after 3 months.The use of laser guarantees total relief of the disease without risk of relapse.
The rehabilitation period after removal of veins.
After surgery, the patient must follow certain rules that will minimize the risk of complications and speed up recovery:
- The use of compression stockings is recommended.The treating doctor will help you with your choice.At first (approximately 5 days), underwear is not removed before bedtime, and subsequently it is allowed to be worn only during the day.
- To support blood vessels, alcohol and smoking should be prohibited, as nicotine and alcohol are one of the most common causes of varicose veins.
- You should refrain from excessive physical activity.Even minor injuries to the lower extremities pose a danger.If the patient previously played sports, he will be able to play sports again after 1.5 to 2 months.
- To avoid relapses, water procedures should not be hot.Sauna, steam bath and solarium are contraindicated.
- Cosmetic procedures cannot be performed on the operated areas.
- It will be useful to perform therapeutic exercises.
To prevent varicose veins from recurring after surgery, during the rehabilitation period you will need to take medications prescribed by your doctor to help the vessels recover.It is undesirable to change the dosage of medications at your own discretion, which entails undesirable consequences.If any signs of deterioration appear, it is important to immediately go to a phlebologist.
The type of surgical intervention is determined depending on the individual characteristics of the disease.
Possible complications after surgery
No specialist can guarantee the total absence of side effects after surgery.Complications may occur depending on the surgical treatment method that was used.
Phlebectomy and extraction can result in:
- numbness in the lower legs;
- decreased skin sensitivity;
- pain syndrome;
- bleeding;
- bruises;
- suppuration of the operated area.
After sclerotherapy the following may appear:
- swelling of the ankle and foot;
- pigmentation;
- peeling and itching;
- painful sensations;
- skin burn.
If an LED laser was used, the formation of:
- inflammation;
- darkening of skin areas;
- minor bruising;
- persistent pain.
The most dangerous complication of any surgical procedure is thrombosis.But its appearance is observed in rare cases.With minimally invasive surgery, the risk of blood clots is quite low.
Thanks to surgical treatment, it is possible to successfully get rid of a serious disease.The main thing is to find a qualified specialist and not ignore medical recommendations regarding the recovery period.