Choosing the best way to treat varicose veins is an urgent problem faced by patients and phlebologists. In the early stages of pathological development, conservative treatment methods are mainly used, which makes it possible to preserve varicose veins. However, if this technique proves to be ineffective, the only suitable option that can improve the situation is to surgically remove leg veins. Surgical intervention is the most thorough method to treat varicose veins, because the remote areas of damaged blood vessels cannot change the varicose veins again.
In this article, we will consider the types of varicose vein surgery that modern vascular surgery can provide: their characteristics, advantages and disadvantages, preparation and implementation characteristics, as well as rehabilitation and possible complications.
What effect can leg vein surgery achieve?
Surgical intervention for varicose veins aims to solve the following problems:
- Eliminate reflux-pathological reflux caused by venous valve failure.
- Remove varicose veins. If the vein has undergone a severe transformation and there is no hope of restoring normal blood flow in it, it is recommended. In this case, the part of the blood vessel that affects the varicose veins is removed, and the blood in it is redistributed through healthy veins.
- Fight appearance defects. Since CVI (Chronic Venous Insufficiency) and the varicose veins caused by it cannot change the appearance of the lower limbs in the best way, the purpose of surgery is especially to eliminate aesthetic defects.
Types of vein surgery
The types of surgical interventions that modern vascular surgery can provide to treat varicose veins are divided into two groups:
- Surgery designed to mechanically remove varicose veins affected by varicose veins and then ligate them.
- Operations related to heat or chemical exposure of varicose veins.
Choosing the most suitable leg vein surgery depends on the development stage of the pathology, the age and general health of the patient, and the goals pursued during the operation.
Phlebectomy of veins of the lower extremities: surgical procedure
Combined phlebectomy (phlebectomy) is the "gold standard" in the practice of treating varicose veins.
This method aims to remove dilated varicose veins.
There are several varieties of the operation, each of which is named after its inventor: according to Bebkokk's phlebectomy, Narat's statement, Mueller's statement, these operations are local (with extensive vascular disease-general) anesthesiaUnder.
Despite the differences, all of these leg vein removal procedures have one thing in common: they involve making 1 mm to 5-6 cm long incisions or punctures in the skin, through which the vascular surgeon uses special methods to be affected. The affected vein is pulled to the surface. hook. The vein is cut, tied and removed, and then sutures or special plasters are applied to the skin. This surgery to remove varicose veins in the legs is very effective and allows you to achieve positive results in treating venous disease.
Laser vein surgery
With the development of traditional Chinese medicine in the vascular surgeon's arsenal, compared with traditional surgery, more modern and less traumatic phlebectomy methods have begun to appear. With their help, the operation time can be reduced, postoperative scars can be reduced, and the possibility of complications and side effects can be reduced. One of the methods is laser surgery (intravenous, intravascular or intravascular laser coagulation) on the veins of the lower extremities.
A special laser light guide is inserted into the cavity of the affected blood vessel, heating the blood and vein walls. Under the influence of a high temperature of up to 120 degrees, the blood vessel walls stick together, so blood stops flowing into this part of the circulatory system.
Expert Opinion
Depending on the area of the lesion and the number of veins to be removed, the treatment of varicose veins in this way usually requires several procedures lasting 30-60 minutes.
The surgical trauma of removing veins with laser is small, the cosmetic effect is good (there will be no obvious scars and scars on the skin afterwards), and long-term hospitalization is not required. However, it should be noted that this technique is not suitable for the treatment of advanced varicose veins. When the diameter of the vein is significantly increased and there is varicose veins, it needs traditional surgical intervention to eliminate it. .
Sclerotherapy
This is another modern phlebectomy procedure that allows you to achieve significant results with minimal trauma. The sclerosing agent is injected into the lumen of the dilated blood vessel-a special liquid or foamy substance that sticks the walls of the affected area of the vein together. A course of sclerotherapy allows you to quickly achieve cosmetic results without leaving scars, so it is very popular. However, this procedure is only suitable for the initial stage of varicose veins and telangiectasia.
Radiofrequency vein surgery
RFA (Radio Frequency Occlusion) is the effect of radio signals of a certain frequency on the affected area of the blood vessel, resulting in heating of the vein wall, destruction of the endothelium and subsequent closure of the vascular cavity. The surgery is minimally invasive and does not require hospitalization.
Preparing for vein surgery
Before the operation, it is necessary to take preparatory measures: venous ultrasound of the lower extremities, clinical blood test and coagulation chart. On the eve of surgery, you need to shave your legs without using creams, gels, and other cosmetics.
Expert Opinion
If you plan to have a general anesthesia, you should fast for 8 hours before the operation (although in some cases, your doctor may allow some snacks). In addition, a clean enema may be required before general anesthesia.
Contraindications for lower extremity vein surgery
These surgical interventions are not recommended during pregnancy, in the case of severe endocrine and cardiovascular diseases, when chronic diseases worsen, in the presence of infection and inflammatory processes in the legs.
Recovery after vein surgery
The duration of the recovery period depends on the number of veins removed, the patient’s general health, and his compliance with the phlebologist’s recommendations.
Usually, the recovery period lasts from 2 months to 6 months.
Depending on the type of surgery, the patient may be advised to perform limited activities during the recovery period. For example, after laser coagulation and sclerotherapy, you can get up and move immediately. After sclerotherapy, you have to walk for about an hour, while combined phlebectomy requires a certain amount of time to be restricted.
Rehabilitation advice after leg vein surgery
In order to reduce the risk of recurrence and complications after surgery, some restrictions and recommendations should be followed:
- You should wear knitwear with the right degree of compression. Tights or stockings after vein surgery are a prerequisite for normal blood flow in the lower limbs.
- Correct the load on the legs. It is important to choose the "Golden Mean" here: it is not allowed to stand still, sit, or run for a long time.
- Do not lift heavy objects (during the recovery period, the maximum allowable weight is 5 kg).
- Do not take a hot bath, do not take a steam bath or sauna, and avoid contact with the skin for a period of time in remote vein areas exposed to direct sunlight.
- Wear loose pants or skirts and give up tight, uncomfortable shoes (especially high heels).
- Take the medicine prescribed by the doctor. In most cases, prescribed intake of venotonics, anticoagulants, and antioxidants.
Consequences and complications after vein surgery
Any surgical intervention will have undesirable consequences, and lower limb vein surgery is no exception. Potential complications include:
- Varicose veins recurred. If the root cause of varicose veins is not eliminated, the possibility of recurrence of the disease is high. Therefore, in addition to surgery on leg veins, a comprehensive treatment of pathology is needed to eliminate predisposing factors.
- Rise in temperature. It is normal for a slight increase in local temperature in the area of the vein after the resection. In addition, the overall body temperature can be maintained at a sub-heat level within 1-2 days after the operation.
- hematoma. Bruising after venous surgery is a common complication after phlebectomy. It is caused by perforation of blood vessels. Small bruises usually disappear within a few weeks without additional treatment. However, if your large painful bruise does not go away in about 2 weeks, please report it to your phlebologist.
- Hyperpigmentation disorders. The discoloration of the skin at the surgical site usually lasts for several weeks and then subsides. It should be remembered that hyperpigmentation is a very common complication after sclerotherapy.
To avoid these unpleasant phenomena, please don't ignore medical advice, be sure to wear elastic stockings and take medications recommended by a phlebologist.