Treatment of varicose veins of the lower limbs: the conservative and surgical methods

The varicose veins are not just an aesthetic problem. We're talking about a serious threat to the health or even life. The first sign of the disease, your doctor should start the treatment.

Varicose veins

Let's see, what treatments the drug.

A modern approach to the treatment of varicose veins

Hard to underestimate the prevalence of this disease, because according to statistics, affects about 75% of the women 60% men. Only among the inhabitants of the developed countries. In order to explain the cause of varicose veins, you should have an idea of the structure of the veins of the lower limbs. The venous blood in the legs moving steadily upward, overcoming the gravity, the implementation of this process, the veins are equipped with special valves which prevent the liquid fell between the jolts of the heart. Disorder this mechanism provokes the reverse current of the venous blood, because the larger the number, the blood vessels dilate, dropping your voice.

The first stage of the varicose veins usually goes away without special symptoms, except that it is accompanied by mild discomfort in the legs, and "heaviness" in the evening. You may notice that your feet are tired even after short walks. The second sub-compensation stage, these functions are increased, and aching pain, swelling, tingling in legs, cramps.

Third, de-compensatory stage is characterized by irreversible changes in the skin of the shins:

  • edema that are not fully converged even after sleep;
  • hyper pigmentation;
  • indurate — seals exposed skin.

Thus, the skin is vulnerable, it's possible, varicose veins, eczema, as well as the finale, nutritional disorders, ulcers. Ignoring the disease can have to face such complications as thrombophlebitis and thromboembolism.

The sooner treatment begins, the more hopeful will be the prognosis. But after all, success should be to change your lifestyle, it's time for preventive procedures.

Suspected varices should be a reason of the early visit to the doctor, which helps to identify the disease, determine the stage.

Diagnosis — the first step towards healing

Varicose veins in the legs

In particular, the doctor interviewing the patient to collect a history. Remains a standard inspection as well as palpation of the affected areas. A detailed, accurate diagnostic ready-to-use duplex ultrasound examination with color mapping of blood flow. The procedure is as simple ultrasound, the only difference is that in addition to two-dimensional images the doctor sees that the speed, direction of movement mapping, the blood flow in the vessels. Modern ultrasound machine can accurately determine the idle valve vein segments with abnormal direction of the blood flow, to accurately indicate the projection on the skin.

If the diagnosis needs to be clarified, it's time to start taking action to get rid of varicose veins.

Conservative treatment of varicose veins

The non-surgical methods to prevent, inhibit or alleviate the disease. As the main method of treatment they are used only in the case if the operation is not possible.

Conservative methods are the following:

  • Compression therapy, i.e. the special compressive underwear or elastic bandage. Effect constricts the veins, thus facilitating the operation of the valve and improves the blood circulation. Effectiveness of compression therapy has demonstrated that a number of studies. There are contraindications including atherosclerosis, aortoarteritis, inflammatory skin diseases, and others.
  • Drug therapy includes medications such as oral administration or local application (in the form of ointments). The groups of drugs for the treatment of varicose veins in the legs include venotonic and anti-inflammatory medicines, anticoagulants (blood thinners). Necessary medication prescribed by the doctor separately. It is important to note, that for everyone there are contraindications. For example, most tablets venotonic not be taken in early pregnancy or if breast-feeding. And, if you're taking anticoagulants need regular blood tests of the clotting.

The primary treatment in the absence of obstacles and contraindications to appoint one of the options of surgical treatment.

The traditional surgery (venectomy)

Currently, only in certain cases related to the special structure of the veins or complicated course of the disease, for example, various forms of acute thrombophlebitis.

The veins in the legs

During the operation, the ligation of the assembly in the trunk of the affected vein, the saphenous, the deep system (crossectomy) and further mechanical removal of the barrel. Manipulation is performed under general anesthesia or spinal anesthesia lasts 1-2 hours. Due to the high incidence of post-operative complications — hematomas in places of removal of the trunk, prolonged pain, skin neuralgia and paresthesias (numbness) in recent years, the traditional surgical intervention gives way to modern methods. These include endo-venous laser photocoagulation.

After the surgery, we recommend that regular physical activity is not a significant load and a half months shows, compression therapy.

In addition to this treatment method, there are other, more subtle ways to get rid of varicose veins on your legs.

Minimally invasive techniques

There are several types of minimal invasive methods of treatment of varicose veins. Based on the data of the patient, as well as the characteristics of the disease, the physician decides to continue proceedings.

Endo-venous laser photocoagulation

Operation endo-venous laser treatment has become the method of treatment of varicose disease of any severity. No severe venous insufficiency, or thickness of the lumen of venous trunks is currently not limited by the endo-venous laser treatment. This is due to the use of the following tools:

  • two waves laser of a wave absorption of hemoglobin, the second and the vessel wall;
  • the radial fibers, which allows the machining of the entire circumference of the inner surface of the vein;
  • automatic pump that allows to pump the anesthetic solution around the vein to provide pain relief, reduce the diameter of the vein, and protection of the adjacent tissues.

Special preparation for endo-venous laser treatment is not necessary. Before the operation, necessarily carried out duplex ultrasound examination. It is also necessary that the blood of the standard preoperative studies: general, biochemistry, coagulogram.

During the procedure, the doctor inserts the affected vein, and then insert a thin (1 mm) catheter with a light guide. This is the whole process, as well as the position of the light guide in Vienna, as well as the more "beer" to Vienna is controlled by intraoperative ULTRASOUND device. The operation lasts for approximately 40 minutes, requires only local anesthesia.

Spider veins on the legs

After surgery spent in the hospital is not necessary, the patient must wear a compression garment for 3 to 5 days within a few weeks recommended daily relaxing walks.

Radio frequency ablation

The operation is essentially similar to laser coagulation. The only difference is that the walls of the veins in the "closure" and subsequent absorption effect of radio frequency radiation. Special training, in addition to the standard preoperative, it is not necessary.

Currently, the connection to the improvement of the laser systems have the advantages of the endo-venous laser photocoagulation, radiofrequency ablation is not. However, the procedure is more expensive due to the high price of the waveguide of.

The operation cannot be performed during pregnancy or during lactation, atherosclerosis hardening of the arteries of the lower limb, the inability of later physical activity.

Possible complications, or a complex of remedial measures during the rehabilitation period similar to the previous procedure.

Mini-phlebectomy

The principle of operation is to remove the tributaries and components of the vein through the puncture or incision in the skin using special tools. Used isolated varicose tributaries, or an additional procedure after the laser coagulation, radio frequency ablation, and surgical phlebectomy.

Training is similar to the previous procedures, the standard test is an ultrasound examination of the veins. Contraindications: pregnancy or breast-feeding, acute infectious diseases, thrombophlebitis, decreased motor activity, pathology of blood clotting.

The duration of the mini-phlebectomy is 20-40 minutes, during rehabilitation it is necessary to wear compression stockings.

Sclerotherapy

Non-surgical methods of varicose vein treatment is suitable for advanced varicose veins, as well as for aesthetic purposes — the destruction of vascular "stars" and "veins".

Treatment of varicose veins

Contraindications thrombosis, Allergy, infection, pregnancy, breast-feeding, the inability to perform accurate injections.

Sclerotherapy involves injection into a vein puncture is a special substance that "glues" the vessel wall that occur after the absorption. One of the latest innovations in method, the foam is foam, which includes foam in the form of the drug. So it's the least washed away the blood, which allows to reduce the concentration and quantity of the material with greater efficiency. The operation is performed without anesthesia, to insert, requiring only a thin insulin needle.

Side effects of sclerotherapy include pigmentation, which appears in the course sklerozirovanie Vienna. In some cases, incomplete bonding, Vienna, which requires you to re-treatments.

After sclerotherapy, you need to wear a compression garment and avoid strenuous activities, as well as the high temperature (for example, if a visitor of the sauna).

The price of sclerotherapy depending on the volume. Removal of large varicose trunks sclerotherapy is now almost never used. And sclerotherapy small nodes or venous nets price from 7,000 to 20,000 rubles.


The development of the drug, the battle for the varicose veins in the legs move the category to the "hundred years war" category, the "quick wins". Sophisticated surgical techniques have given way to minimally invasive procedures safer, effective. Today, varicose veins are not a sentence, but only to the specialist.