The types of treatment of the veins of the legs of the men and women did not differ, however, the frequency of the recurrences and postoperative complications in women above in connection with the additional effect of hormones (estrogenic influence).
Venous disorders of the leg must be treated by a doctor-phlebologist, that takes care of this pathology. Different methods of treatment of varicose veins are not radical, as it does not aim to eliminate the main pathogenetic cause – failure of the valve unit of vienna. Surgical and conservative treatment to delay the progression of the disease in the long line. The percentage of recurrence is high, and reaches from 10% to 50% after 5 years after surgery.
Treatment of varicose veins must be global. Distinguish three groups of methods of resolution of varicose veins:
- surgical,
- conservative.
Each type of treatment has its advantages and disadvantages, a certain frequency of recurrence. The choice of method is influenced, as well as phlebologist to reach a compromise often must combine all the three methods.
The characteristic symptoms of varicose veins in women
Common manifestations specific to women
The symptoms of varicose veins begin with the occurrence of such functional disorders as the feeling of heaviness in the legs, swelling of the ankle at the end of a work day. On the skin of the legs before they form the varicose veins.
The main signs of the disease – the unification of the varicose veins extended to the subcutaneous veins, appear after a few years of the beginning of the disease.
In the absence of treatment in this phase, you experience these symptoms such as cramps in the calf, itching of the skin of the feet.
The signs of the alterations in trophic: the pigmentation of the skin in the lower third of the tibia, cyanosis, sclerotic changes of the subcutaneous tissue, eczema, the background of which is formed trophic ulcer.
The characteristic symptoms of varicose veins in women
- The painful symptoms appear cyclically, and are enriched before the loop, which is associated with the change in the level of sex hormones;
- during pregnancy found signs of varicose veins after childbirth can disappear;
- during the second half of the menstrual cycle due to the action of progesterone, a diameter of varicose veins increases, then the symptoms of swelling and heaviness in the legs, are expressed as;
- signs of varicose veins acute during hormonal therapy.
Now let's talk about therapy techniques.
The best treatment methods
The ablation, and laser coagulation
The ablation of the veins
The method is based on the introduction of, under ULTRASOUND control special disposable catheter into the lumen, extended to vienna.
The catheter is equipped with a special electrode, the part of work which, under the action of the radio frequency heats up to 120 degrees. The promotion of the catheter in the course of the vein leads to bonding of the vascular wall. The veins affected are disabled from the circulatory system of the legs.
Venous laser coagulation
The technique of intervention consists of the puncture of the vein in question and the introduction to the land of his under ultrasound guidance laser light guide. Under the action of laser irradiation, coagulation of the protein of the vascular wall, resulting in the vienna subside and after a while covered with connective tissue.
Radiofrequency ablation and venous laser obliteration are relatively new methods of treatment of varicose veins in the legs. Despite the differences in technical execution, they have common characteristics.
The advantages and disadvantages of radiofrequency ablation and vein obliteration with laser
Advantages:
- Not in need of hospitalization;
- The speed of execution (from 30 min to 1 hour);
- Painless;
- Bloodless;
- Are performed under local anesthesia;
- The absence of the postoperative scar (the desired for women aesthetically, the effect);
- A short time of rehabilitation.
Disadvantages:
- The high price;
- The frequency of recurrence of up to 10%;
- The impossibility to carry out the procedures in some of the anatomical features of the veins (strong sinuosity of the blood vessels).
Radiofrequency ablation and venous laser obliteration, choose the women they want to treat varicose veins in outpatient settings with a minimum of restriction of physical activity in the postoperative period, and keeping an aesthetic appearance of the legs.
Fleboskleroterapija
On the ground struck by a segment of a vein, is introduced in a special drug that has a specific action on the vascular wall. The agent sclerotherapy can be used in liquid form or in the form of a foam. Preference should be given sclerotherapy with foam due to the increased area of contact of the substance with the wall of the vein.
The advantages and disadvantages Fleboskleroterapija:
- The absence of the postoperative scar;
- It takes place in outpatient settings;
- The operation is performed without anesthesia;
- The handling is virtually painless (slight burning sensation at the puncture site);
- It is possible to along the pigmentation of the skin at the place of drilling (up to 2 years);
- In rare cases, the inflammation postoperative the veins (phlebitis);
- Swelling and redness of the tissues within 2 days after the treatment;
- An allergic reaction in case of hypersensitivity to the drug;
- In 20% of cases appear to be varicose veins on legs (telangiectasias);
- The frequency of recurrence by up to 50%.
Relapse after sclerotherapy of varicose veins depends on the level you hit the ship - the largest in the land, the higher the risk of recanalization in it. This therapy choose in the treatment of recurrence of varicose veins after surgery flebectomia.
Surgical flebectomia
Surgery is the most radical way to eliminate varicose veins. Principles of surgical treatment are in liquidation pathological rejection of blood from the deep to the surface veins of the legs and removal of the same extended blood. The phases of the combined flebectomia:
- The intersection and ligation of the mouth of the great saphenous (incision in the groin) or small saphenous (incision in the popliteal fossa);
- Removal of the trunks, of varicose veins. Is made with the help of a special metal probe, which pulls vienna in the cutting of the skin.
Advantages:
- The radicality;
- The possibility to perform operations at any stage of the disease.
Disadvantages:
- Hospitalization for 5 to 7 days;
- Tripe in the foot;
- Spinal anesthesia or general;
- Injury to surrounding tissues when you pull of vienna;
- Possible complications: bleeding, infection of the wound;
- The frequency of recurrence of up to 20%.
Treat surgically, preferably with a certain kind of defeat, when it occurs with varicose veins or deformation of large or small saphenous veins to a considerable course. And even when there are signs of alterations in the trophic soft tissue and symptoms of congestive heart failure venous.
Miniflebjektomija
Miniflebjektomija an option of an intervention, in which it is possible to cure varicose veins of the legs in the initial stages. This is applied in the presence of the unity of the varicose veins extended to the nodes on the shins. Is performed the puncture of the skin above the pathological formation, and with the help of a hook exposed, and intersects vienna. The operation does not require general anesthesia, and the overlapping leather stitching.
Conservative therapy
Start to treat varicose veins disease in the feet is must with the use of drugs and compression therapy. The appointment of drugs for improving blood circulation and wear compression stockings – the main conditions that determine the outcome of each intervention on the veins of the legs.
Medical therapy
Drugs cut symptoms of venous insufficiency, apply as preoperative preparation and postoperative rehabilitation.
Treat rates medicines varicose veins on the legs, is in need of a long period, continuously or in the form of a repeating cycle.
Compression therapy
Elastic compression of the foot – the main method of treatment in those cases, when surgery is contraindicated. As graduated compression stockings medium, it is possible to use elastic bandages and special medical mesh: socks, knee-highs, tights. Medical products are of high resistance, long time keep the compression level, close to the wrist, which is important for women as well.
There are 4 classes of elastic mesh depending on the degree of compression. Recommended to treat varicose veins with the use of products of class 2 in the absence of disease progression for a period of up to 6 months and with the further application and during physical exercise or during prolonged standing. If there are signs of injury of the venous valves in deep or cast the symptoms of disorders of the lymph, are assigned to the links of class 3 until the stop of the progression of varicose veins.
The therapeutic effect of compression stockings is due to:
- reduction of the volume of vienna, which leads to a lower rejection of the blood in varicose veins blood;
- the increase of extraction of interstitial fluid into the blood circulation, thanks to signs of swelling and the symptoms of heaviness in the legs disappear;
- improve the fluidity of the blood, which prevents the formation of blood clots.