Conservative treatment methods are effective only in the initial stages of varicose veins.And since the first signs are usually ignored, 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
In the presence of varicose veins, surgical treatment is prescribed in certain cases.
In particular, surgical intervention is indicated in patients with:
- extensive vascular damage that 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.
Surgery for varicose veins is suitable when the use of drugs does not give the desired results.It is important to prevent the progression of the disease to the point where surgical treatment is useless.
For some patients, varicose vein surgery may be contraindicated.
Contraindications
End-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 diseases (coronary artery disease, hypertension, heart failure);
- acute form of phlebitis;
- infectious diseases (operation is possible after recovery);
- venous thrombosis, pulmonary embolism (anamnesis);
- obliterating atherosclerosis of the vessels of the lower extremities.
Surgical treatment to remove varicose veins is contraindicated in patients over 70 years of age, as well as in pregnant women.
Preparation for surgery
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 about the operation.
You should also describe the available symptoms as accurately as possible, talk about possible intolerance to certain drugs and do not forget to inform about the drugs you are currently taking.
The attending physician refers the patient to a number of diagnostic procedures:
- blood and urine tests;
- fluorography;
- electrocardiography;
- duplex sonography.
The preparatory stage requires compliance with certain conditions:
- 3 days before the operation, the patient must adhere to a diet without slags, i.e.fried, salty, spicy, as well as meat and flour are prohibited.
- The last meal and fluid intake is 8 hours before surgery.
- At least for 3 days you should forget about 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 tell your doctor.
If the patient drives a car, arrangements should be made for a relative or acquaintance to pick him 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 for him and how much such treatment costs.If the 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.
Ways to remove 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 partially or completely removed, in others, veins that have been 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 cut out.After removal, blood flow will be 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.Subsequently, 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 carry out all the necessary manipulations with the vein.In addition, recovery in this case is much faster and no scars remain.
All types of surgery performed to remove varicose veins on the legs go well and in very rare cases cause complications.
Thanks to this puncture technique, it is possible to get rid of even large varicose veins.
Undressing
This is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon pulls 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.
Undressing happens:
- partially– only part of the venous vessel is cut;
- total– the diseased vein is stretched along with its small branches.
Carrying out such manipulations requires maximum attention from the doctor.If at least one unobstructed inflow remains, the risk of relapse increases significantly.
Sclerotherapy
This is an operation to remove progressive varicose veins that 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 completely disappears.
To do this, a sclerosant is injected into the vein.The drug promotes irreversible damage to the walls of the vessel with subsequent overgrowth of the lumen.
Medicines specifically designed for this purpose are usually used.
Sclerotherapy has several advantages:
- the procedure can be performed on an outpatient basis;
- the patient can 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 forms a foam that 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.In addition, in order to obtain satisfactory results, 1-2 procedures are carried out, in 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 the deep veins.The injection is performed with the help of an ultrasound scanner, which allows to clearly distinguish the injection site of the sclerosant, to determine the exact amount of the drug and to avoid unwanted consequences.
The performed manipulations are practically painless, and subsequently 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 - a laser LED.
It is injected into the affected vein and thanks to its radiation, the inner 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:
- 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 assessed after 3 months.The use of a laser guarantees a complete cure of the disease without the risk of recurrence.
Rehabilitation period after vein removal
After the operation, the patient must follow certain rules that will minimize the risk of complications and speed up recovery:
- Compression stockings are recommended.The attending physician will help with its selection.In the beginning (about 5 days), the underwear is not removed before going to bed, and subsequently it is allowed to use it only during the day.
- In order to maintain blood vessels, alcohol and smoking should be prohibited, as nicotine and alcohol are among the most common causes of varicose veins.
- You should refrain from excessive physical activity.Even minor injuries to the lower limbs are a danger.If the patient was previously a sports fan, he can return to exercise after 1.5-2 months.
- To prevent relapses, water treatments should not be hot.The sauna, steam bath and solarium are contraindicated.
- Cosmetic procedures cannot be performed on the operated areas.
- It will be useful to do therapeutic exercises.
To prevent the return of varicose veins after surgery, during the rehabilitation period you will need to take drugs prescribed by your doctor to help the vessels to recover.It is not desirable to change the dosage of drugs at your discretion, which is fraught with undesirable consequences.If 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 occur depending on the method of surgical treatment.
Phlebectomy and stripping can lead to:
- numbness in the lower part of the 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 burning.
If a laser LED is used, the formation of:
- inflammation;
- darkening of skin areas;
- light bruising;
- 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.