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 there are varicose veins, surgical treatment is prescribed in certain cases.
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 bring 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 in the legs may be contraindicated.
Contraindications
Late-stage surgery is often inappropriate;accordingly, varicose veins are treated with different drugs.They help to slightly reduce the severity of the disease, but 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);
- obliterative atherosclerosis of the vessels of the lower extremities.
Surgical treatment for the elimination of varicose veins is contraindicated in patients over 70 years old, as well as in pregnant women.
Preparation for surgery
A consultation with a phlebologist will help you prepare properly for the upcoming surgical treatment.The patient has the right to ask any question that interests him about 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 refers the patient to undergo a series of diagnostic procedures:
- blood and urine tests;
- fluorography;
- electrocardiography;
- duplex sonography.
The preparatory phase requires compliance with several conditions:
- 3 days before the operation, 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 is 8 hours before surgery.
- For at least 3 days you should forget alcohol and cigarettes.
- You will need to remove the hair from the leg where the operation will be performed and you must use a razor.
- If there are ulcers, hematomas or any skin damage, you should notify your doctor.
If the patient drives a car, they should arrange for someone close or known to pick them up after discharge.It is currently prohibited to drive.
When preparing for surgery, the patient is interested in what type of surgical intervention is indicated 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, etc.
Methods for removing varicose veins
Since there are many types of surgical treatment for varicose veins, the choice of a specific technique is based on diagnostic data.In some cases, the venous vessel is partially or completely removed, in others, the veins that are deformed due to varicose veins are closed or narrowed using a special substance.
Phlebectomy
A type of surgical treatment during which the areas of blood vessels where varicose veins are present are removed.After removal, blood movement will be carried out through 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.Afterwards, a small scar remains at the operated site.
Microphlebectomy
An excellent alternative to the previous method.The essence of the technique is that there is no need to make 5 mm incisions.A small needle is enough to carry out all the necessary manipulations with the vein.In addition, healing in this case is much faster and no scars remain.
All types of operations performed to eliminate varicose veins of the legs go well and cause complications in very rare cases.
Thanks to this piercing technique, it is possible to get rid of even large varicose veins.
exposure
It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon takes out the vessel affected by varicose veins through a small incision, using a special probe.The incisions are made in the area of the inguinal fold and the ankle from the inside.
Undressing occurs:
- partial– only part of the venous vessel is cut;
- total– the diseased vein lies together with its small branches.
Carrying out such manipulations requires maximum care from the doctor.If at least one uncrossed branch remains, the risk of relapse 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 induces irreversible damage to vessel walls with subsequent increase in 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;
- After the operation there are no marks.
A negative point is the possibility of re-formation of varicose veins.The disease can affect the veins located near those where the sclerosant was injected.In one procedure, up to 10 injections are performed and the duration of the treatment is about an hour.
It should be said about the types of sclerotherapy:
- Foam.The used medicine, in contact with air, forms 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 obtain satisfactory results, 1-2 procedures are performed, during which the foam is injected a maximum of 3 times.
- Microsclerotherapy.The technique is suitable in the initial stages of the disease.
- Echosclerosis.Prescribed for lesions of deep veins.The injection is done using an ultrasound scanner, which makes it possible to clearly distinguish the injection site of the sclerosant, determine the exact amount of the drug and avoid unwanted consequences.
The manipulations performed are practically painless and patients recover quickly afterwards.
Laser coagulation
This method of treating varicose veins, called endovenous laser coagulation (endovasal) (disappearance), involves the use of a special device - a laser LED.
It is injected into the affected vein and thanks to its radiation, the inner surfaces of the vessel are joined together.Blood continues to circulate through healthy veins and the patient's well-being improves.
Advantages of laser coagulation:
- lack of scars and age spots on the skin;
- performed 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 judged after 3 months.The use of a laser guarantees complete relief from the disease without the risk of relapse.
Rehabilitation period after vein removal
After surgery, the patient must follow some rules, which will minimize the risk of complications and speed up recovery:
- It is recommended to wear compression stockings.The attending physician will help in his selection.In the beginning (about 5 days), the underwear is not removed before going to bed, and then it is allowed to use them only during the day.
- To support blood vessels, alcohol and smoking should be stopped, 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 risk.If the patient was previously fond of sports, he can return to training 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 in the 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 vessels recover.It is undesirable to change the dosage of drugs at your discretion, which is fraught with undesirable consequences.If any signs of deterioration appear, it is important to immediately consult 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 complete absence of side effects after surgery.Complications can occur depending on the method of surgical treatment that was used.
Phlebectomy and stripping can result in:
- numbness in the lower legs;
- decreased skin sensitivity;
- pain syndrome;
- bleeding;
- hematoma;
- suffocation of the operated area.
After sclerotherapy, the following may appear:
- ankle and foot swelling;
- pigmentation;
- skin and itching;
- painful sensations;
- skin burning.
If a laser LED is used, the formation of:
- inflammation;
- darkening of skin areas;
- minor bruises;
- nagging 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 to ignore medical recommendations regarding the recovery period.