Varicose veins are a disease characterized by changes in the vascular condition in the legs with impaired blood flow. When the shape is neglected, the veins swell, causing swelling and pain in the limbs (under load) and aesthetic discomfort. Surgical removal of damaged vessels is effective for this stage.
Tips for varicose vein surgery
Surgery for varicose veins can be performed only if there are instructions to remove the blood vessels:
- varicose veins affected most of the vein;
- severe pain and swelling of the legs that interfere with normal life during physical exertion;
- formation of open wounds and ulcers against the background of disease development. It is dangerous to add a secondary infection;
- Impaired blood flow through the arteries, often accompanied by convulsions;
- significant development of vascular necrosis;
- A pathological change in the blood vessels accompanied by dilation and elongation. The change is dangerous with vascular trauma and at the same time causes aesthetic discomfort;
- blood clots in the arteries.
Surgery is allowed only with advanced forms of varicose veins and in the absence of dynamics with conservative treatment.
Absolute and relative contraindications to surgery
For varicose veins, the operation to remove the leg veins is performed not only in the presence of indications, but also in the absence of contraindications:
| List of Relative Prohibitions | |
| Stable high blood pressure | Presence of infectious diseases |
| Regular jumps in pressure | Dermatological pathologies affecting the skin of the legs |
| Chronic heart disease | Inflammatory processes in the body, including blood vessels |
| Age forward after 70 years. | Recovery period after other surgeries |
| Presence of cancers | Chemotherapy |
| Diabetes mellitus and severe asthma | Severe soft tissue injury from trauma |
| Thinness and fragility of blood vessels | Acute liver and kidney pathologies |
| Patients with limited mobility (paralysis) or bedridden patients | Blood clotting disorder or anemia |
| Varicose veins in the last stage | Taking hormones, antibiotics or other aggressive medications |
| Presence of complex leg fractures (damaging blood vessels and nerve endings) | Being overweight |
| Allergic reaction to drugs used during surgery | Patient's refusal to operate |
When carrying a child, there may be a violation of the condition of the blood vessels in the legs. More often, the pathology resolves spontaneously after delivery. When there are contraindications, surgical intervention is dangerous with worsening of the patient's condition and even a fatal outcome.
Phlebectomy
Phlebectomy is a surgical procedure to remove damaged blood vessels and restore normal blood flow to the deep veins.
Anatomical meaning, great surgical technique for vascular removal
The circulatory system in the legs consists of a deep vein and many branches of superficial veins that affect the varicose veins. Changes in vascular function develop due to valve dysfunction. During normal vascular function, the valves close, allowing blood to flow in only one direction.
People with varicose veins do not have caps on their arteries, as a result of which the blood can move in both directions, which leads to blood stasis and disruption of blood flow due to the elongation of the arteries.
In order to restore the blood supply to the muscle, it is necessary to remove the affected vessel (with reverse blood flow), ie perform phlebectomy. Before the operation, the patient undergoes preparation (taking tests, scanning the condition of the vessels, determining the general condition of the patient).
If there are no contraindications, specialists perform surgery in the following stages:
- Access to the affected vessel is provided by a small incision (in the groin or popliteal, depending on the location of the vessel). The damaged vein is then connected to a deep vein to prevent blood flow.
- An incision is made near the varicose vein. With the use of a probe, a vein is separated from the muscle tissue, lymphatic system and small capillaries. The damaged vessel is removed through a tube or using a fork.
- Capillaries are treated to prevent bleeding.
- If there are damaged capillaries forming spider veins, they are removed.
- Finally, cosmetic sutures, disinfectant dressings and elastic bandages are applied.
The operation is performed under general or local anesthesia. It depends on the size and location of the ship.
Efficiency level
Surgical removal of veins is used at different stages of development of varicose veins. The procedure is very effective (more than 98%). Restoration of blood circulation occurs in a short time.
Rehabilitation
The effectiveness of the procedure depends not only on the specialty of the surgeon, but also on compliance with the rules in the postoperative period.
After phlebectomy, you need:
- suture care in a hospital for 7-14 days;
- Wearing compression stockings or elastic bandages for 30 days is carried out day and night;
- After 30 days, 3 more months, wear specialized clothing during the day
- foot washing water operations (where the operation is performed) are possible only after the stitches are removed;
- saunas, baths and hot tubs are prohibited during the recovery period;
- Postoperative pain medication is prescribed by a doctor. Self-selection is prohibited;
- Additional medications are taken to prevent blood clots;
- take medications to strengthen the walls of blood vessels (vitamins E and C);
- It is forbidden to stand / sit for a long time wearing high heels and tight underwear;
- In the supine position, the legs should be above body level during the rest period. Promotes excess blood flow and reduces swelling;
- Apply physical activity in a timely and gradual manner to normalize blood circulation (discuss with your doctor);
- massages and physiotherapy are performed with the permission of the attending specialist;
- Abstain from alcohol and nicotine. Alcohol causes vasodilatation, and tobacco, in contrast, causes them to constrict. These effects reduce the efficiency of the operation;
- If you are overweight, a low-calorie diet is prescribed.
If the rules are followed, it is possible to fully restore the function of the joint within 6 months.
Endovenous coagulation using a laser
The operation to remove varicose veins in the leg using a laser is performed when direct vessels with a diameter of at least 0. 02 cm are affected and there are few capillaries. The procedure consists of the effect of light waves on the damaged vessels with subsequent soldering and destruction.
Equipment
Laser coagulation of blood vessels can be performed with one of 3 types of optical fibers:
| Optical fiber type | Activity Short |
| Last (classic) | This light guide emits radiation from the end, ie it is attached to the front of the dish. The downside is the formation of hematomas and a painful feeling of constriction of blood vessels. Maximum vessel diameter 0, 1 cm. |
| Radial (elves with painless radial light guide) | Light waves from the fiber form a circle wrapped around the diameter of a vein. This allows the vessels of any size to be treated. It also minimizes the risk of hematoma formation and swelling. |
| 3 types of radial fiber | Lasers with two light rings are used to remove varicose veins. The first prepares the vessel for the procedure (removes excess fluid), the second soldering the walls of the circle. For the treatment of thin and short veins and light guides for large veins are produced. |
Equipment selection is made not only by the patient, but also by the specialist involved in the condition of the vessels.
Which vessels can be removed by EVLK method
Before choosing an EVLK, a phlebologist (a specialist who examines the veins and removes varicose veins) determines the characteristics of the damaged veins. They must be straight and at least 2 mm in diameter.
As a result, laser therapy can be applied to the following groups of vessels:
- small and large sapenous veins;
- safen accessory veins at least 5 mm from the surface of the epidermis;
- Veins that connect deep veins with superficial veins.
Therapy for other vessels is possible only with phlebectomy.
Efficiency
Removal of vessels by EVLK method is possible with 3 types of optical fiber. The effectiveness of treatment varies depending on the type of equipment. The effectiveness of therapy when performing an operation using a light guide is 94-96%. Working with radial light guides allows you to achieve 100% results in the removal of varicose veins in the legs.
Preparation and implementation stages
When choosing to remove varicose veins using EVLK, the patient should undergo the following exercises:
- Cancellation of hormonal drugs (if any). Because it can lead to the development of thrombosis;
- blood thinners are required the day before the intervention;
- examination of damaged vessels to determine the degree of damage;
- Get tests to rule out the presence of a latent infection or inflammatory process in the body. Blood clots are also identified;
- The place of the procedure is thoroughly washed and shaved (only antibacterial soap is allowed without the use of cosmetics).
Prior to surgery, the boundaries of the damaged vessels, the laser / fiber placement area, and the location of the branching capillaries are noted. These marks allow you to solder the beginning and end of the vessel, as well as the outlet of the capillaries. The process is carried out under the supervision of an ultrasound machine.
EVLK is produced in stages:
- Placing the catheter through a small hole (the place where the catheter is placed is anesthetized with local anesthesia). The light guide will move along it.
- Inserting the light guide into the catheter and then moving it towards the damaged area. It is performed under ultrasound control on a monitor.
- Anesthetic injection to reconcile vascular and adjacent tissues.
- Advance of the "active" light guide through the damaged vein, followed by a delay in the branches of the capillaries (to close the outlets and prevent bleeding).
- Removal of the laser puncture site with antiseptic treatment and application of an elastic bandage (or the use of compression stockings).
After completing the procedure, the patient can leave the hospital immediately.
Rehabilitation features
In order to restore the function of the injured joint and prevent the development of complications, you should be familiar with the nuances of rehabilitation after EVLK.
These are:
- After the procedure, it is recommended to walk the operated leg for an hour in a medical facility;
- Ultrasound examination of the treated vein is performed within 2-3 days;
- It is necessary to wear specialized underwear day and night for 5 days (the type of socks is discussed with the attending specialist before the operation). Then clothes should be used during the day for 45-60 days;
- Knead your feet daily for 60 minutes every day;
- Avoid overloading the legs (sitting or standing for long periods of time) and visiting saunas or taking hot baths.
If removal of varicose veins is still required, the procedure is allowed to be performed no later than 7 days.
Advantages of each method
Depending on the type of intervention, leg vein removal surgery for varicose veins has the following advantages:
| Phlebectomy | EVLK |
| The incisions for the operation are about 5 mm, so there are no wounds left | No pain during the procedure (using local anesthesia). General anesthesia is not required |
| Painless as the operation is performed under local anesthesia. Local anesthesia is used for miniphlebectomy. | EVLK is performed under ultrasound control. The result is high accuracy and efficiency. |
| Low price | Hematomas and pain at the site of surgery are rare or mild. |
| Rapid recovery of skin tone (absence of stars and purple-cyanotic shade of the epidermis) | 1 hole is required for the operation, so no stitches or scars are needed |
| Short recovery time of about 30 days | Recovery time up to 5 days |
| Effective for all forms of varicose veins | After the operation, the patient can leave the clinic within 1 hour. |
| It is possible to return to normal life within 24 hours. | |
| EVLK can be performed when the integrity of the epidermis is compromised by ulcers. | |
| The duration of the surgery is not more than 40 minutes. | |
| EVLK can be done on both feet in one day. On one leg, a second operation is allowed after 7 days. |
Because the cut / puncture is small, the risk of infection during the procedure is minimal.
Complications after surgery and laser vascular surgery
There is a risk of complications after surgical or laser removal of blood vessels. Adverse reactions may occur due to the low qualification of a specialist or violation of the rules during the rehabilitation period. Possible complications of phlebectomy and endovenous coagulation.
| Vein Removal Methods | Minor complications from procedures | Major Complications |
| Phlebectomy |
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| Endovenous laser coagulation |
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Allergic reactions to anesthetics may develop during both operations.
Measures to minimize complications
Surgery to remove varicose veins is sometimes accompanied by the development of complications, to prevent their appearance:
- testing for allergic reactions to drugs used;
- exclusion of infectious diseases and inflammatory processes in the body before surgery;
- selection of clinics with highly qualified specialists and proven modern equipment;
- Compliance with the rules during the recovery period. Wear especially compressed underwear;
- Observe diet during recovery (discussed by a specialist after the procedure). The amount of pure water in the diet increases, food intake is divided into smaller portions, the diet is enriched with vitamins and minerals;
- rest legs during work;
- to be examined to monitor the dynamics of recovery of the extremities after surgery;
- Massage and participate in physiotherapy procedures to quickly restore blood flow.
If you find unacceptable deviations during this operation, you should contact the clinic immediately.
Comparison of forecasts
The probability of complete recovery with both leg vein removal methods is more than 95%, but it is subject to the elimination of contraindications, adherence to the rules during rehabilitation and when choosing a proven clinic. With surgical treatment, blood flow and external condition of the legs are restored after 3 months, and recovery is noted after 30 days with laser therapy.
In advanced forms, removal of blood vessels is performed by surgery. The method of treatment is determined not only by the patient's wishes, but also by the presence of indications and contraindications for the procedure. The effectiveness of therapy depends on the doctor's habits and adherence to postoperative foot care.