Treatment of varicose veins of the lower extremities: conservative and surgical techniques

Varicose veins is not only an aesthetic Problem. It's going to be a serious threat to the health and even life. At the first signs of the disease, consult a doctor and begin treatment.


Let's find out what methods of treatment medicine can offer.

Modern approach to the treatment of varicose veins

Hard to the prevalence of this disease is appreciated, because it is suffering according to statistics, about 75% of women and 60% men. And this is only among the inhabitants of the developed countries. To explain the cause of the formation of varicose veins, you must have an idea about the structure of the veins of the lower extremities. The venous blood in our feet, moving relentlessly upward, overcoming the laws of gravity — for the realization of this process, the veins are equipped with special valves that prevent the liquid sink to the bottom in the breaks between the contractions of the heart. Malfunction of this mechanism provokes reflux of the venous blood, and because of the larger volume of the veins to expand, which reduces its Tonus.

The first stage of varicose veins in General, without special symptoms, accompanied by insignificant complaints in the area of the legs and the "weight" of the evening. You may find that the legs hike after a bit. On the second, sub-compensation stage, these features are intensified, and even pain and swelling occur, tingling in legs, cramps.

The third, de-many, stage by irreversible changes in the skin of the lower leg:

  • Swelling, which are not completely even after sleep;
  • Hyper pigmentation;
  • indurate seals occurring skin.

This skin is easily vulnerable, it is possible, varicose eczema and how the final trophic disorders, ulcers. Disregard of the pathology is due to complications such as thrombosis and thromboembolism.

The earlier treatment begins, the more enjoyable the prognosis is. But even after the success achieved, we need to style our lives, so that time for preventative treatments.

Suspected varicose veins should be a reason for early visits to the doctor, which will help to identify the disease and define its stage.

Diagnosis — the first step to recovery

Varicose veins on the legs

Especially the specialist for the care of elderly patients is necessary for the collection of medical history. Further, a Standard inspection and Palpation of the disease affected areas should be. For more detailed and accurate diagnostic ultrasound Duplex used Angio-scan with color mapping of blood flow. The procedure looks like a simple ultrasound with the only difference that in addition to the two-dimensional images of the doctor, the speed and direction of movement mapping of blood flow in the vessels. Modern ultrasound equipment allows you to determine exactly defective valves, the sections of the veins with the of the pathological the direction of the movement of the blood, just refer to their projection on the skin.

After the diagnosis is refined, it's time to start, measures for the elimination of varicose veins.

Conservative treatment of varicose veins

With the help of non-surgical methods you can prevent, slow down or facilitate the course of the disease. As the primary method of treatment whose benefits only if an Operation is not possible.

Among the conservative methods:

  • Compression therapy, i.e. the use of a special compression underwear or elastic bandages. Their effect constricts the veins, making the work of the valves and the improvement of blood circulation. The effectiveness of compression therapy many studies have proven. There are contraindications — among them, atherosclerosis, aortoarteriit, inflammatory diseases of the skin and other.
  • The drug therapy involves the use of medications such as for the ingestion and local application (in the Form of ointments). On groups of drugs for the treatment of varicose veins in the legs-inflammatory drugs, anticoagulants (blood-thinning) include venous and inflammation. The necessary medicines the doctor prescribes individually. It is important to remember that everyone has contra-indications. For example, most of the pre-formed venotonic not take at the beginning of the pregnancy and while breastfeeding. And in taking the anticoagulants Tests on blood clotting must on a regular basis.

As a primary treatment if there are no obstacles and contra-indications one of the options of operative treatment.

Traditional surgery (venectomy)

Currently, it is only in certain cases, in connection with the special structure of the veins or complicated course of the disease, for example, in the case of various forms of acute Thrombophlebitis.

The veins on the feet

The Operation consists in the ligation of the confluence of the tribe of the affected saphenous vein in the deep System (crossectomy) and further mechanical removal of the root. The Manipulation is performed under General anesthesia or with a spinal anesthesia and lasts for 1-2 hours. Due to the high frequency of post-operative complications — hematomas in the areas of removal of the trunk, prolonged pain, cutaneous neuralgia, and paresthesia (numbness) — in recent times, the traditional surgical Intervention gives way to modern methods. To do this, Endo-venous Laser photocoagulation include.

After the surgery the regular locomotor activity without a significant impact for one or one and a half months recommend shows the compression therapy.

In addition to this method of treatment there are others that get rid of more "gentle" way of varicose veins on the legs.

Minimally Invasive Techniques

There are several varieties of low-traumatic methods of treatment of varicose veins. On the basis of data about the patient and the specifics of the disease, the physician in charge of the procedure shall decide on the feasibility of implementation.

Endo-venous Laser coagulation

The surgery, Endo-venous laser coagulation has been the method for the treatment of varicose veins of each severity. Neither the severity of the venous insufficiency, neither the strength of the venous lumen of the tribe are currently no restrictions for Endo-venous laser coagulation. This was made possible through the use of the following instruments:

  • two-wave Laser with the Absorption of a wave by hemoglobin, and the second circuit-wall;
  • Radial light control system, a treatment, in the circumferential direction of the inner surface of the vein;
  • the automatic pump, the pumps of anesthetic solution around Vienna, providing pain relief, a reduction in the diameter of the vein, the protection of the adjacent tissue.

A special training of the Endo-venous laser coagulation is not necessary. Before the Operation, absolutely Duplex ultrasound performed. Also may require blood donation to the Standard of the preoperative range of analyses: General, biochemistry, coagulogram.

During the procedure, the doctor will puncture injected into the affected vein, after which a thin (1 mm thick) catheter with light conductor leads. This whole process, and also the Position of the fiber in Vienna, and for more "brew" Vienna controlled device intra-operative ULTRASOUND. The Operation takes about 40 minutes and requires just local anesthesia.

Spider veins on the legs

After the surgery is not necessary in a hospital, the Patient must of a special compression wear compression garment for 3-5 days, and in a couple of weeks recommended daily quiet walks.

Radio-Frequency Ablation

The process is essentially similar to the Laser-coagulation. The only difference is that on the wall of the vein for their "closure" and the subsequent absorption of radio frequency radiation. Special training, apart from the usual preoperative, is not required.

Currently, in connection with the improvement of laser systems, not advantages over the Endo-venous Laser coagulation, radio frequency Ablation, has. But the method is expensive in connection with higher cost of waveguide.

The Operation can not be performed during pregnancy and lactation, in the case of atherosclerosis of the arteries of the lower extremities, and the subsequent impossibility of motor activity.

Possible complications and complex-reducing measures during the Rehabilitation period are not comparable with the previous procedure.


The principle of Operation consists in the removal of tributaries and node Vienna by punctures or incisions made on the skin with the help of special Tools. It is in the case of the isolated varicose tributaries or as an additional procedure after the Laser coagulation, or surgical radio-frequency Ablation phlebectomy.

The preparation is similar to the previous method — a Standard set of Tests, as well as an ultrasound examination of the veins. Contraindications — pregnancy and breast-feeding, acute infectious diseases, thrombosis, violation of the motor activity, the pathology of the blood coagulation.

The duration of the Mini-phlebectomy is 20-40 minutes, during Rehabilitation compression must wear stockings.


Non-invasive method of treatment of varicose veins is suitable for advanced varicose veins, and for aesthetic reasons, used for the destruction "of the gemsternchen" and "veins".

Treatment of varicose veins

Contraindications serve Thrombophlebitis, individual allergic reactions, infections, pregnancy, and lactation, the impossibility of a precise injection.

Sclerotherapy is the introduction into a vein by puncture of a special substance, which sticks the walls of the container to the time of his absorption. One of the latest innovations — method of foam-foam the use of foam forms of the drug. Thus, it is wash, to a lesser extent with blood, that it is possible to lower concentrations and quantities of the substance through the increase in efficiency. The Operation is performed without anesthesia, so as for the puncture requires only a thin Insulin needle.

Among the side effects of sclerotherapy pigmentation that appears in pursuance of sklerozirovannoy the veins. In some cases, incomplete bonding of Vienna demand that the execution repeat the procedure.

After sclerotherapy worn compression clothing, and avoid physical exertion and high temperatures (e.g., during a visit to the Sauna).

The price of sclerotherapy is dependent on the volume exported. For the removal of large varicose veins strains sclerotherapy is now used practically. And a session of sclerotherapy small nodes or venous networks in a cost of 7000 to 20 000 rubles.

With the development of medicine in the fight against varicose veins on the legs for quick success moved from the category of "hundred years war" in the category "". Complex surgical techniques, wich is the minimum to make invasive procedures safer and at the same time more efficient. Today is not a judgment, just an opportunity to see a specialist is varices.