Conservative treatment methods are effective only in the initial stages of varicose veins.And since the first signs usually remain unattended, 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 varicose veins are present, surgical treatment is prescribed in some cases.
In particular, the surgery is indicated for patients with:
- extensive vascular damage, which can be determined by visual examination;
- symptoms in the form of swelling, constant aching pain and feeling of heaviness;
- significant risk of thrombophlebitis, trophic ulcers.
Surgery on varicose veins is appropriate when the use of drugs does not bring the desired results.It is important to prevent the disease from developing to the point where surgical treatment is futile.
For some patients, surgery for varicose veins on the legs may be contraindicated.
Contraindications
Late-stage surgery is often inappropriate;as a result, varicose veins are treated with various medications.They help to slightly reduce the severity of the disease, but cannot eliminate it completely.
Patients affected by:
- inflammatory skin diseases at the site of development of venous pathology (for example, erysipelas or eczema);
- cardiovascular disorders (coronary heart disease, hypertension, heart failure);
- acute form of phlebitis;
- infectious diseases (surgical intervention is possible after recovery);
- venous thrombosis, pulmonary embolism (anamnesis);
- obliterating atherosclerosis of the vessels of the lower limbs.
Surgical treatment to eliminate varicose veins is contraindicated in patients over 70 years of age, as well as pregnant women.
Preparation for surgery
A consultation with a phlebologist will help you properly prepare for the upcoming surgical treatment.The patient has the right to ask any questions that interest him regarding the operation.
You should also describe the symptoms present as accurately as possible, talk about possible intolerance to certain medications and be sure to inform about the medications you are currently taking.
The attending physician directs the patient to undergo a series of diagnostic procedures:
- blood and urine tests;
- fluorography;
- electrocardiography;
- duplex ultrasound.
The preparatory phase requires compliance with certain conditions:
- 3 days before surgery, the patient must adhere to a slag-free diet, that is, fried, salty, spicy, as well as meat and flour products are prohibited.
- The last meal and fluid intake are 8 hours before surgery.
- For at least 3 days you should forget about alcohol and cigarettes.
- You will need to remove hair from the leg on which the operation will be performed and you should use a razor.
- If there are ulcers, hematomas or any damage to the skin, you should notify your doctor.
If the patient drives a car, he or she should be accompanied by someone close or familiar after discharge.Driving is currently prohibited.
When preparing for surgery, the patient is interested in what type of surgical intervention is indicated to him and how much such 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 and so on.
Methods for removing varicose veins
Since there are many types of surgical treatment of varicose veins, the choice of a specific technique is made based on diagnostic data.In some cases, the venous vessel is removed partially or completely, in others, the veins deformed due to varicose veins are sealed or narrowed with a special substance.
Phlebectomy
A type of surgical treatment in which areas of blood vessels where varicose veins are present are removed.After removal, the movement of blood will be carried out through the deep veins.
The operation is performed as follows:
- After the anesthesia has taken effect, the surgeon makes small incisions (up to 5 mm).
- The vein is removed using a special probe, after which the affected area is resected.
The duration of phlebectomy is 1-2 hours.Subsequently, a small scar remains at the operated site.
Microphlebectomy
A great 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, recovery in this case is much faster and no scars remain.
All types of operations performed to eliminate varicose veins in the legs are fine and cause complications in very rare cases.
Thanks to this puncture technique it is possible to eliminate even large varicose veins.
Striptease
It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon extracts 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.
Stripping occurs:
- partial– only a part of the venous vessel is removed;
- total– the diseased vein lengthens along with its branches.
Performing 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 remove progressive varicose veins, which is minimally invasive and does not require any 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 resulting in excessive growth of the lumen.
Usually drugs specially designed for this purpose are used.
Sclerotherapy has several advantages:
- the procedure can be performed on an outpatient basis;
- the patient can return to daily activities the next day;
- general anesthesia is not necessary;
- There are no scars after the operation.
A negative point is the probability of reformation of varicose veins.The disease can affect veins located next to where the sclerosant was injected.Up to 10 injections are performed in one procedure, and the duration of treatment is approximately one hour.
It should be said about the types of sclerotherapy:
- Foam.The drug used, in contact with air, forms foam which fills the cavity of the vessel.Closure of the lumen occurs in a short period of time and even a small amount of sclerosant is sufficient.Further, to obtain satisfactory results, 1-2 procedures are carried out, during which the foam is injected a maximum of 3 times.
- Microsclerotherapy.The technique is appropriate in the initial stages of the disease.
- Ecosclerosis.Prescribed for lesions of the deep veins.The injection is performed using an ultrasound scanner, which allows you to clearly distinguish the injection site of the sclerosant, accurately determine the amount of the drug and avoid unwanted consequences.
The performed manipulations are practically painless, and patients recover quickly afterwards.
Laser coagulation
This method of treating varicose veins, called intravenous (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 together.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;
- carried out 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 complete relief from the disease without risk of recurrence.
The rehabilitation period after vein removal
After surgery, the patient must follow some rules that will minimize the risk of complications and speed up recovery:
- It is recommended to wear compression stockings.Your doctor will help you with your choice.Initially (about 5 days) underwear is not removed before going to bed and subsequently it is only allowed during the day.
- To support blood vessels, alcohol and smoking should be banned, 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 limbs pose a danger.If the patient was previously fond of sports, he can return to physical activity after 1.5-2 months.
- To prevent relapses, water procedures should not be hot.Sauna, Turkish bath and solarium are contraindicated.
- Cosmetic procedures cannot be performed on the operated areas.
- It will be useful to perform therapeutic exercises.
To avoid the recurrence of varicose veins after surgery, during the rehabilitation period it will be necessary to take the drugs prescribed by the doctor to promote the recovery of the vessels.It is undesirable to change the dosage of drugs at your own discretion, which is fraught with undesirable consequences.If signs of deterioration appear, it is important to immediately consult a phlebologist.
The type of surgical intervention is determined based on the individual characteristics of the disease.
Possible complications after surgery
No specialist can guarantee the complete absence of side effects after surgery.Complications may occur depending on the surgical treatment method used.
Phlebectomy and stripping can cause:
- numbness in the lower legs;
- decreased skin sensitivity;
- pain syndrome;
- bleeding;
- hematomas;
- suppuration of the operated area.
After sclerotherapy the following may appear:
- swelling of the ankle and foot;
- pigmentation;
- scaling and itching;
- painful sensations;
- skin burn.
If a laser LED was used, the formation of:
- inflammation;
- darkening of skin areas;
- small bruises;
- nagging pain.
The most dangerous complication of any surgical procedure is thrombosis.But its presence 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.