Conservative treatment methods are only effective in the initial stages of varicose veins.And since the first signs usually go unnoticed, the pathology continues to develop and reduces 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 certain cases.
In particular, surgical intervention is indicated for patients with:
- extensive vascular damage, which can be detected by visual examination;
- Symptoms in the form of swelling, constant pain and heaviness;
- significant risk of thrombophlebitis and trophic ulcers.
Varicose vein surgery makes sense if the use of medication does not bring the desired result.It is important to prevent the disease from progressing to the point where surgical treatment is futile.
In some patients, surgery for varicose veins on the legs may be contraindicated.
Contraindications
Surgery at the final stage is often inappropriate;Accordingly, varicose veins are treated with various medications.They help to slightly reduce the severity of the disease, but cannot completely eliminate it.
Patients suffer from:
- inflammatory skin diseases at the site of development of venous pathology (for example, erysipelas or eczema);
- cardiovascular diseases (coronary heart disease, hypertension, heart failure);
- acute form of phlebitis;
- Infectious diseases (surgery is possible after recovery);
- Venous thrombosis, pulmonary embolism (anamnesis);
- obliterating arteriosclerosis of the vessels of the lower extremities.
Surgical treatment to eliminate 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 optimally prepare for the upcoming surgical treatment.The patient has the right to ask any questions that interest him in connection with the operation.
You should also describe the symptoms as precisely as possible, talk about possible intolerance to certain medications and be sure to inform them about which medications you are currently taking.
The attending physician refers the patient for 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 follow a slag-free diet, that is, fried, salty, spicy, meat and flour products are prohibited.
- The last meal and fluid intake takes place 8 hours before the operation.
- You should avoid alcohol and cigarettes for at least 3 days.
- You will need to remove hair from the leg where the surgery will be performed using a razor.
- If you have ulcers, hematomas or other skin damage, be sure to notify your doctor.
If the patient drives a car, they should be picked up by someone close or familiar to them 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 a patient is scheduled to undergo 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 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 other cases, the veins deformed by varicose veins are closed or narrowed with a special substance.
Phlebectomy
A type of surgical treatment that involves removing areas of blood vessels where varicose veins are present.After removal, blood movement occurs through deep veins.
The process is carried out as follows:
- After anesthesia begins, the surgeon makes small incisions (up to 5 mm).
- The vein is removed using a special probe and the affected area is then resected.
The duration of the phlebectomy is 1-2 hours.A small scar will then remain at the surgical site.
Microphlebectomy
An excellent alternative to the previous method.The essence of the technique is that it does not require 5mm incisions.A small puncture is enough to carry out all the necessary manipulations on the vein.In addition, recovery in this case is much faster and no scars remain.
All types of operations 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 remove even large varicose veins.
Strip
It is a type of phlebectomy.With its help, the trunk of the great saphenous vein is removed.The surgeon uses a special probe to pull out the vessel affected by varicose veins through a small incision.The incisions are made in the area of the groin fold and the ankle on the inside.
Stripping happens:
- partially– only part of the venous vessel is excised;
- in total– The diseased vein is stretched with its small branches.
Carrying out such manipulations requires the utmost care from the doctor.If at least one uncrossed tributary 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 sclerosing agent is injected into a vein.The drug promotes irreversible damage to the vascular walls with subsequent overgrowth of the lumen.
As a rule, drugs specially developed for this purpose are used.
Sclerotherapy has several advantages:
- the procedure can be carried out on an outpatient basis;
- The patient is allowed to return to everyday activities the next day.
- no general anesthesia required;
- No scars remain after the operation.
A negative point is the likelihood of new varicose veins forming.The disease can affect the veins located next to the veins into which the sclerosant was injected.Up to 10 injections are carried out in one procedure and the treatment lasts about an hour.
The types of sclerotherapy include:
- Foam.The drug used forms foam when it comes into contact with air, which fills the cavity of the vessel.Lumen closure occurs in a short time and even a small amount of sclerosing agent is sufficient.In addition, to achieve satisfactory results, 1-2 procedures are carried out, during which the foam is injected a maximum of three times.
- Microsclerotherapy.The technique is suitable in the early stages of the disease.
- Echosclerosis.Prescribed for lesions of deep veins.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 drug and avoid undesirable consequences.
The manipulations performed are practically painless, and patients subsequently recover quickly.
Laser coagulation
This method of treating varicose veins, called endovenous (endovasal) laser coagulation (obliteration), uses a special device - a laser LED.
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;
- performed on an outpatient basis for 1-2 hours;
- Local anesthesia is used;
- Manipulations are carried out under the control of an ultrasound device;
- short recovery period.
The success of the operation can be finally assessed after 3 months.The use of a laser guarantees complete relief of the disease without the risk of relapse.
The rehabilitation phase after vein removal
After the operation, the patient must follow certain rules that will minimize the risk of complications and speed up recovery:
- Wearing compression stockings is recommended.The attending physician will help you choose.Initially (approx. 5 days) the underwear is not removed before going to bed and can then only be worn 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 avoid excessive physical activity.Even minor injuries to the lower extremities pose a danger. If the patient was previously fond of sports, he or she can do sports again after 1.5 to 2 months.
- To avoid relapses, water procedures should not be hot.Sauna, steam bath and solarium are contraindicated.
- No cosmetic procedures can be performed on the operated areas.
- It will be useful to perform therapeutic exercises.
To prevent varicose veins from reoccurring after surgery, you need to take medications prescribed by your doctor during the rehabilitation period that will help restore the vessels.It is undesirable to change the dosage of medications 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 depends on the individual characteristics of the disease.
Possible complications after surgery
No specialist can guarantee the complete absence of side effects after surgery.Depending on which surgical treatment method was used, complications may occur.
Phlebectomy and stripping can result in:
- numbness in the lower legs;
- reduced skin sensitivity;
- pain syndrome;
- bleeding;
- hematomas;
- Suppuration of the operated area.
The following symptoms may occur after sclerotherapy:
- swelling of the ankle and foot;
- Pigmentation;
- peeling and itching;
- painful sensations;
- Skin burn.
When using a laser LED, the formation of:
- Inflammation;
- darkening of skin areas;
- easy bruising;
- excruciating pain.
The most dangerous complication of any surgical procedure is thrombosis.However, its occurrence is observed in rare cases.With minimally invasive procedures, the risk of blood clots is quite low.
Thanks to surgical treatment, it is possible to successfully eliminate a serious illness.The main thing is to find a qualified specialist and not ignore medical recommendations regarding the recovery period.