Conservative treatment methods are effective only in the initial stages of varicose veins.And since the first signs are usually left 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 adhere to medical recommendations.
Indications for surgery
If varicose veins are present, surgical treatment is prescribed in certain cases.
Surgical intervention is especially indicated for patients with:
- extensive vascular damage, which can be determined by visual inspection;
- symptoms in the form of swelling, constant pain and a feeling of heaviness;
- significant risk of thrombophlebitis, trophic ulcers.
Varicose veins surgery is suitable when the use of drugs does not give the desired results.It is important to prevent the disease from progressing to the point where surgical treatment is futile.
For some patients, surgery for varicose veins on the legs may be contraindicated.
Contraindications
Surgery in the last stage is often inappropriate;consequently, varicose veins are treated with various drugs.They help to reduce the severity of the disease a little, but they cannot completely eliminate it.
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 blood vessels of the lower extremities.
Surgical treatment for the removal of varicose veins is contraindicated in patients older than 70 years, as well as in 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 all the questions he is interested in regarding the operation.
Also, you should describe the present symptoms as precisely as possible, discuss possible intolerance to certain medications and be sure to inform about the medications you are currently taking.
The doctor refers the patient to a series of diagnostic procedures:
- blood and urine tests;
- fluorography;
- electrocardiography;
- duplex sonography.
The preparatory phase requires compliance with certain conditions:
- 3 days before surgery, the patient must adhere to a diet without slag, that is, fried, salty, spicy, as well as meat and flour products are prohibited.
- The last meal and liquid is 8 hours before surgery.
- Forget about alcohol and cigarettes for at least 3 days.
- You will need to remove hair from the leg where the surgery will be performed and use a razor.
- If there are ulcers, hematomas or any skin damage, you must inform your doctor.
If the patient drives a car, he should arrange for someone close or familiar to pick him up after discharge.Driving is currently prohibited.
When preparing for surgery, the patient is interested in what type of surgical intervention is indicated for him and how much such treatment costs.If the patient is scheduled for vein surgery, the price is influenced by numerous factors: the stage of the disease, the length of the vein 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 selection of a specific technique is based on diagnostic data.In some cases, the vein is partially or completely removed, in others, veins that are deformed due to varicose veins are sealed or narrowed using a special substance.
Phlebectomy
A type of surgical treatment during which parts of the blood vessels where varicose veins are present are cut out.After removal, the blood flow will be through the deep veins.
The operation is performed as follows:
- After the anesthesia takes 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 1-2 hours.Afterwards, a small scar remains on the operated site.
Microphlebectomy
An excellent alternative to the previous method.The essence of the technique is that there is no need for 5 mm incisions.A small puncture is enough to perform all the necessary manipulations with the vein.Moreover, recovery in this case is much faster, and scars do not remain.
All types of operations performed to remove varicose veins on the legs go well and in very rare cases cause any complications.
Thanks to this puncture technique, it is possible to get rid of even large varicose veins.
Downloading
It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.Using a special probe, the surgeon pulls out the vein affected by varicose veins through a small incision.The incisions are made in the area of the inguinal fold and the ankle joint from the inside.
The download is happening:
- partially– only part of the venous vessel was excised;
- in total– the diseased vein stretches together with its small branches.
Performing such manipulations requires maximum attention from the doctor.If at least one uncrossed tributary remains, the risk of recurrence increases significantly.
Sclerotherapy
This is an operation 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 it disappears completely.
To do this, a sclerosant is injected into a vein.The drug promotes irreversible damage to vessel walls with subsequent growth of the lumen.
Medicines specially designed for this purpose are usually 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;
- no need for general anesthesia;
- There are no scars after the operation.
A negative point is the probability of re-formation of varicose veins.The disease can affect the veins located next to those where the sclerosant was injected.In one procedure, up to 10 injections are made, and the duration of the treatment is about an hour.
It should be said about the types of sclerotherapy:
- Foam.The medicine used in contact with air creates foam, which fills the cavity of the container.The closure of the lumen occurs in a short period of time, and a small amount of sclerosant is sufficient.In addition, to achieve satisfactory results, 1-2 procedures are carried out, during which the foam is injected a maximum of 3 times.
- Microsclerotherapy.The technique is suitable in the initial stages of the disease.
- Echosclerosis.It is prescribed for lesions of deep veins.The injection is performed using an ultrasound scanner, which enables a clear distinction of the sclerosant injection site, precise determination of the amount of the drug and avoidance of unwanted consequences.
The performed manipulations are practically painless, and after that the patients recover quickly.
Laser coagulation
This method of treating varicose veins, called endovenous (endovasal) laser coagulation (obliteration), involves the use of a special device - laser LED.
It is injected into the affected vein, and thanks to its radiation, the inner surfaces of the vessels are welded.Blood continues to circulate through healthy veins, and the patient's condition improves.
Advantages of laser coagulation:
- absence of scars and age spots on the skin;
- it is carried out on an outpatient basis for 1-2 hours;
- local anesthesia is used;
- manipulations are performed under the control of an ultrasound machine;
- short recovery period.
The success of the operation can be finally evaluated after 3 months.The use of the laser guarantees complete relief from the disease without the risk of recurrence.
Rehabilitation period after vein removal
After surgery, the patient must follow certain rules that will reduce the risk of complications and speed up recovery:
- It is recommended to wear compression stockings.The attending physician will help him choose.In the beginning (about 5 days), underwear is not removed before going to bed, and later it is allowed to use it only during the day.
- To maintain blood vessels, alcohol and smoking should be prohibited, because 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 are dangerous.If the patient used to play sports, he can return to exercise after 1.5-2 months.
- To prevent relapses, water procedures should not be hot.Sauna, steam bath and solarium are contraindicated.
- Cosmetic procedures cannot be performed on operated areas.
- It will be useful to perform therapeutic exercises.
To prevent the return of varicose veins after surgery, during the rehabilitation period you will need to take medications prescribed by your doctor to help the blood vessels recover.It is undesirable to change the dose of drugs at your own discretion, which is fraught with unwanted consequences.If any signs of deterioration appear, it is important to see a phlebologist immediately.
The type of surgical intervention is determined depending 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 arise depending on which method of surgical treatment was used.
Phlebectomy and stripping can result in:
- numbness in lower legs;
- reduced skin sensitivity;
- pain syndrome;
- bleeding;
- hematomas;
- suppuration of the operated area.
The following may occur after sclerotherapy:
- ankle and foot swelling;
- pigmentation;
- peeling and itching;
- painful sensations;
- skin burns.
If a laser LED is used, forming:
- inflammation;
- darkening of skin areas;
- minor bruises;
- excruciating pain.
The most dangerous complication of any surgical procedure is thrombosis.But its occurrence 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 cure a serious disease.The main thing is to find a qualified specialist and not to ignore medical recommendations regarding the recovery period.